Page 127 - Medicare Benefit Policy Manual

maintenance, or replacement of equipment in the frequent and substantial servicing or
oxygen equipment payment categories. In addition, payments for repair and maintenance
may not include payment for parts and labor covered under a manufacturer’s or supplier’s
warranty.

A. Repairs

To repair means to fix or mend and to put the equipment back in good condition after
damage or wear. Repairs to equipment which a beneficiary owns are covered when
necessary to make the equipment serviceable. However, do not pay for repair of
previously denied equipment or equipment in the frequent and substantial servicing or
oxygen equipment payment categories. If the expense for repairs exceeds the estimated
expense of purchasing or renting another item of equipment for the remaining period of
medical need, no payment can be made for the amount of the excess. (See subsection C
where claims for repairs suggest malicious damage or culpable neglect.)

Since renters of equipment recover from the rental charge the expenses they incur in
maintaining in working order the equipment they rent out, separately itemized charges for
repair of rented equipment are not covered. This includes items in the frequent and
substantial servicing, oxygen equipment, capped rental, and inexpensive or routinely
purchased payment categories which are being rented.

A new Certificate of Medical Necessity (CMN) and/or physician’s order is not needed for
repairs.

For replacement items, see Subsection C below.

B. Maintenance

Routine periodic servicing, such as testing, cleaning, regulating, and checking of the
beneficiary’s equipment, is not covered. The owner is expected to perform such routine
maintenance rather than a retailer or some other person who charges the beneficiary.
Normally, purchasers of DME are given operating manuals which describe the type of
servicing an owner may perform to properly maintain the equipment. It is reasonable to
expect that beneficiaries will perform this maintenance. Thus, hiring a third party to do
such work is for the convenience of the beneficiary and is not covered. However, more
extensive maintenance which, based on the manufacturers’ recommendations, is to be
performed by authorized technicians, is covered as repairs for medically necessary
equipment which a beneficiary owns. This might include, for example, breaking down
sealed components and performing tests which require specialized testing equipment not
available to the beneficiary. Do not pay for maintenance of purchased items that require
frequent and substantial servicing or oxygen equipment.

Since renters of equipment recover from the rental charge the expenses they incur in
maintaining in working order the equipment they rent out, separately itemized charges for
maintenance of rented equipment are generally not covered. Payment may not be made