Medicaid billing guidelines for miscellaneous DME items

If you’re billing miscellaneous DME items under Medicaid and submitting them on separate claims with the same date of service (DOS), you may get unnecessary denials. Here's what to know to be sure your claims are accepted and processed correctly.

When you submit multiple claims to DHS for miscellaneous DME items (e.g., procedure codes E1399/K0108) with the same DOS, only one claim is accepted — the others are denied. This results in delays, rework and potential revenue loss.

Consolidate claims with multiple service lines

To avoid denials and streamline prior authorization processing, bill all miscellaneous items on a single claim, using multiple service lines. This approach allows each item to be priced individually while keeping the claim intact.

Incorrect billing format

Claim 1:

• Line 1: E1399/K0108 – $1500.00
• Line 2: E1399/K0108 – $300.00
• Line 3: E1399/K0108 – $150.00

Claim 2:

• Line 1: E1399/K0108 – $750.00
• Line 2: E1399/K0108 – $599.00
• Line 3: E1399/K0108 – $75.00

Result: Only one claim is accepted; the other is denied.

Correct billing format

Single claim with multiple lines:

• Line 1: E1399/K0108 – $1500.00
• Line 2: E1399/K0108 – $300.00
• Line 3: E1399/K0108 – $150.00
• Line 4: E1399/K0108 – $750.00
• Line 5: E1399/K0108 – $599.00
• Line 6: E1399/K0108 – $75.00

In this format, all items are priced per the authorization and processed without denial.

Key takeaways

• Always consolidate miscellaneous DME items onto one claim.
• Use multiple service lines to itemize each billed charge.

This method supports accurate pricing and efficient prior authorization review.