Effective May 13, 2023, the Office of Workers’ Compensation (OWCP) Division of Federal Employees’ Compensation (DFEC) Program is implementing new utilization review (UR) for Durable Medical Equipment (DME) procedure codes and modifier combinations.

Please refer to 23-07 DFEC Circular for additional information.

Procedure Code Modifier New Utilization Review Restrictions
E1800. E1801, E1802, E1805, E1806, E1810, E1811, E1812, E1815, E1816, E1818, E1820, E1821, E1825, E1830, E1831, E1840 RR Rental of extension/flexion device is limited to once in 31 days
E0100, E0105, E0110, E0112, E0114, E0621. E0955, E2378 NU Purchase of patient’s sling or seat is limited to once in 366 days
E0670, E0720, E0730, E0748, E0760 NU Purchase of DME equipment is limited to once in a lifetime
E0156, E0158, E0159, E0731, E2102 NU Purchase of DME equipment is limited to once in 1095 days
E1020 NU Purchase of DME equipment is limited to twice in 1825 days
E1028 NU Purchase of DME equipment is limited to six in 366 days
E0130, E0135, E0140, E0141, E0143, E0144, E0147, E0148, E0149, E0165, E0170, E0171, E0181, E0182, E0183, E0184, E0185, E0186, E0187, E0193, E0194, E0196, E0197, E0198, E0235, E0240, E0245, E0247, E0248, E0250, E0251, E0255, E0256, E0260, E0261, E0290, E0291, E0292, E0293, E0294, E0295, E0301, E0302, E0303, E0304, E0305, E0316, E0471, E0620, E0625, E0627, E0629, E0630, E0635, E0636, E0637, E0638, E0639, E0640, E0641, E0642, E0958, E0968, E0986, E1002, E1003, E1004, E1005, E1006, E1007, E1008, E1010, E1012, E1029, E1030, E1035, E1036, E1038, E1039, E1050, E1060, E1070, E1083, E1084, E1085, E1086, E1087, E1088, E1089, E1090, E1092, E1093, E1100, E1130, E1140, E1150, E1160, E1161, E1170, E1171, E1172, E1180, E1190, E1195, E1200, E1221, E1222, E1223, E1224, E1225, E1226, E1227, E1228, E1230, E1240, E1250, E1260, E1270, E1280, E1285, E1290, E1295, K0800, K0801, K0802, K0806, K0807, K0808, K0812, K0813, K0814, K0815, K0816, K0820, K0821, K0822, K0823, K0824, K0825, K0826, K0827, K0828, K0829, K0830, K0831, K0835, K0836, K0837, K0838, K0839, K0840, K0841, K0842, K0843, K0848, K0849, K0850, K0851, K0852, K0854, K0855, K0856, K0857, K0858, K0859, K0860, K0861, K0862, K0863, K0864, K0868, K0869, K0870, K0871, K0877, K0878, K0879, K0880, K0884, K0885, K0886, K0898, K0899 NU Purchase of DME equipment is limited to once in 1825 days

For additional information, you may contact our Call Center at the number listed below, where a Call Center representative will be happy to assist you.

Division of Federal Employees' Compensation (DFEC):
1-844-493-1966

Posted Date