| Item | Covered | Denied | CMN | SOP | Item Information | ||
• Food Pump
|
X |
Covered if prescribed by a physician as an integral part of the patient's covered enteral or parenteral therapy. The CMN for a food pump must include sufficient medical documentation to establish that the food pump is medically necessary, i.e., that gravity feeding is not satisfactory due to aspiration, diarrhea, dumping syndrome, etc. This information should be listed on Question #15 on the certificate of medical necessity. See ENTERAL EQUIPMENT AND SUPPLIES or PARENTERAL EQUIPMENT AND SUPPLIES. |