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US · guidance

CMS Pub. 100-04, ch. 20, § 130.4

Billing for Certain Customized Items

activein force · 2026-08-25 – presentas-observed

A3-3629, B3-4107.8

Due to their unique nature (custom fabrication, etc.), certain customized DME cannot be

grouped together for profiling purposes. Claims for customized items that do not have

specific HCPCS codes are coded as E1399 (miscellaneous DME). This includes

circumstances where an item that has a HCPCS code is modified to the extent that neither

the original terminology nor the terminology of another HCPCS code accurately

describes the modified item.

Suppliers and providers other than HHAs bill the A/B MAC (B) or DME MAC. HHAs

bill their A/B MAC (HHH), using revenue code 0292 along with the HCPCS.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
a3d3c94b7b23b434e89458c1e229953a45838963c5ea8262bff5bb761b930b59
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