01 | Patient was admitted to a hospital |
02 | Patient was bed confined before the ambulance service |
03 | Patient was bed confined after the ambulance service |
04 | Patient was moved by stretcher |
05 | Patient was unconscious or in shock |
06 | Patient was transported in an emergency situation |
07 | Patient had to be physically restrained |
08 | Patient had visible hemorrhaging |
09 | Ambulance service was medically necessary |
10 | Patient is ambulatory |
11 | Ambulation is Impaired and Walking Aid is Used for Therapy or Mobility |
12 | Patient is confined to a bed or chair |
13 | Patient is Confined to a Room or an Area Without Bathroom Facilities |
14 | Ambulation is Impaired and Walking Aid is Used for Mobility |
15 | Patient Condition Requires Positioning of the Body or Attachments Which Would Not be Feasible With the Use of an Ordinary Bed |
16 | Patient needs a trapeze bar to sit up due to respiratory condition or change body positions for other medical reasons |
17 | Patient's Ability to Breathe is Severely Impaired |
18 | Patient condition requires frequent and/or immediate changes in body positions |
19 | Patient can operate controls |
20 | Siderails Are to be Attached to a Hospital Bed Owned by the Beneficiary |
21 | Patient owns equipment |
22 | Mattress or Siderails are Being Used with Prescribed Medically Necessary Hospital Bed Owned by the Beneficiary |
23 | Patient Needs Lift to Get In or Out of Bed or to Assist in Transfer from Bed to Wheelchair |
24 | Patient has an orthopedic impairment requiring traction equipment which prevents ambulation during period of use |
25 | Item has been prescribed as part of a planned regimen of treatment in patient home |
26 | Patient is highly susceptible to decubitus ulcers |
27 | Patient or a care-giver has been instructed in use of equipment |
28 | Patient has poor diabetic control |
29 | A 6-7 hour nocturnal study documents 30 episodes of apnea each lasting more than 10 seconds |
30 | Without the equipment, the patient would require surgery |
31 | Patient has had a total knee replacement |
32 | Patient has intractable lymphedema of the extremities |
33 | Patient is in a nursing home |
34 | Patient is conscious |
35 | This Feeding is the Only Form of Nutritional Intake for This Patient |
36 | Patient was administered premix |
37 | Oxygen delivery equipment is stationary |
38 | Certification signed by the physician is on file at the supplier's office |
39 | Patient Has Mobilizing Respiratory Tract Secretions |
40 | Patient or Caregiver is Capable of Using the Equipment Without Technical or Professional Supervision |
41 | Patient or Caregiver is Unable to Propel or Lift a Standard Weight Wheelchair |
42 | Patient Requires Leg Elevation for Edema or Body Alignment |
43 | Patient Weight or Usage Needs Necessitate a Heavy Duty Wheelchair |
44 | Patient Requires Reclining Function of a Wheelchair |
45 | Patient is Unable to Operate a Wheelchair Manually |
46 | Patient or Caregiver Requires Side Transfer into Wheelchair, Commode or Other |
47 | Advertisement Run Condition |
48 | Individual Paid for Last Day Worked |
49 | Full Wages Paid for Date of Injury |
50 | Citation or Ticket Issued |
51 | Individual is Member of Policyholder's Household |
52 | Individual Permitted to Use Vehicle |
53 | Individual Wore Seatbelt |
54 | Child Restraint Device in Vehicle |
55 | Child Restraint Device Used |
56 | Individual Injured |
57 | Individual Transported to Another Location |
58 | Durable Medical Equipment (DME) Purchased New |
59 | Durable Medical Equipment (DME) Is Under Warranty |
60 | Transportation Was To the Nearest Facility |
PS | Publication is Included in Sharing |