Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES
Chapter 7 - DURABLE MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS, AND MEDICAL SUPPLIES (DMEPOS)
Section 471-7-002 - DEFINITIONS

Current through September 17, 2024

The following definitions apply.

002.01 APPARENT LIFE-THREATENING EVENT (ALTE). Apparent life threatening events (ALTE) are episodes that are frightening to the observer and characterized by some combination of central or obstructive apnea, color change, marked change in muscle tone, choking, or gagging.

002.02 AUGMENTATIVE COMMUNICATION DEVICES. Augmentative communication devices are any modes of communication other than speech.

002.03 AUTHORIZED DURABLE MEDICAL EQUIPMENT, PROSTHETICS, ORTHOTICS, AND MEDICAL SUPPLIES (DMEPOS) PROVIDER. Providers authorized to prescribe durable medical equipment, prosthetics, orthotics, and medical supplies (DMEPOS) include physicians, nurse practitioners, clinical nurse specialists, or physician assistants.

002.04 BED-CONFINED. The client's condition is such that the client is confined to bed, although not necessarily all of the time.

002.05 CUSTOM FABRICATED. Made for a specific client from his or her individualized measurements.

002.06 CUSTOM FITTED. Substantial adjustments are made to a prefabricated item by a specially trained professional to meet the needs and unique shape of an individual client.

002.07 DURABLE MEDICAL EQUIPMENT. Equipment which:

(A) Withstands repeated use;

(B) Is primarily and customarily used to serve a medical purpose;

(C) Is not useful to a person in the absence of an illness or injury; and

(D) Is appropriate for use in the client's home.

002.08 FACILITY. A nursing facility (NF) regulated by 471 Nebraska Administrative Code (NAC) 12 or intermediate care facility for individuals with developmental disabilities (ICF/DD) regulated by 471 NAC 31.

002.09 MEDICAL SUPPLIES. Expendable or reusable supplies required for care of a medical condition in the client's home. This does not include personal care items or oral or injectable over-the-counter drugs and medications. 002.10 ORTHOSIS. A type of brace which either prevents or assists movement of a limb or the spine.

002.10 ORTHOTICS. Rigid or semi-rigid devices which prevent or correct physical deformity or malfunction, to support a weak or deformed part of the body or eliminate motion.

002.11 PROSTHESES AND PROSTHETICS. An artificial device which replaces a missing body part lost through trauma, disease, or congenital conditions.

002.12 REGISTERED NURSE. A licensed registered nurse in the employment of a durable medical equipment, prosthetics, orthotics, and medical supplies (DMEPOS) provider.

002.13 UTILIZATION MANAGEMENT ORGANIZATION. An organization under contract with the Department to review and approve prior authorization requests.

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