Please click to enlarge.Summary
The Centers for Medicare & Medicaid Services (CMS) is the U.S. Federal agency responsible for the administration of the Medicare program, which provides health insurance to Americans aged 65 and older, as well as younger individuals who are disabled or suffer from End Stage Renal Disease (ESRD) or Lou Gehrig's Disease. CMS makes Basic Stand Alone (BSA) Medicare Claims Public Use Files (PUFs) available to the public for research into the utilization and costs associated with Medicare, including Inpatient, Outpatient, Durable Medical Equipment (DME), Hospice, Skilled Nursing Facility (SNF), and Prescription Drug claims data.
The chart above explores the total allowed from the most recently published DME claims file by age band and ICD-9 diagnosis code category. DME is defined as medically necessary durable medical equipment that is used in the home, such as wheelchairs, crutches, canes, walkers, lifts, hospital beds, blood sugar monitors, infusion pumps and supplies, nebulizers, oxygen equipment, and sleep apnea devices. Diagnosis codes are alphanumeric medical codes used on claims to denote the underlying medical condition that requires the performed service or supplied equipment. Interestingly, it is not the oldest segment of the Medicare population that has the highest DME costs.
ICD-9 Diagnosis Code Categories
| Code Range | Category Description |
|---|---|
| 001-139 | Infectious and Parasitic Diseases |
| 140-239 | Neoplasms |
| 240-279 | Endocrine, Nutritional and Metabolic Diseases, and Immunity Disorders |
| 280-289 | Diseases of the Blood and Blood-Forming Organs |
| 290-319 | Mental Disorders |
| 320-359 | Diseases of the Nervous System |
| 360-389 | Diseases of the Sense Organs |
| 390-459 | Diseases of the Circulatory System |
| 460-519 | Diseases of the Respiratory System |
| 520-579 | Diseases of the Digestive System |
| 580-629 | Diseases of the Genitourinary System |
| 630-679 | Complications of Pregnancy, Childbirth, and the Puerperium |
| 680-709 | Diseases of the Skin and Subcutaneous Tissue |
| 710-739 | Diseases of the Musculoskeletal System and Connective Tissue |
| 740-759 | Congenital Anomalies |
| 760-779 | Certain Conditions Originating in the Perinatal Period |
| 780-799 | Symptoms, Signs, and Ill-Defined Conditions |
| 800-999 | Injury and Poisoning |
| E00-Z99 | External Causes of Injury and Supplemental Classification |
