HCPCS · Medicare DME
BED PAN, STANDARD, METAL OR PLASTIC
Long description on the CMS LCD code table, this read.
Data read from the CMS Coverage API on 2026-10-13. The LCD version is the current final DME MAC LCD on that read. Text below is quoted from those CMS documents. Nothing here is a coverage rule Verzi wrote.
Bed Pans (E0275, E0276) are covered for beneficiaries who are bed-confined (see NCD 280.1 in the “Related National Coverage Documents” section of this LCD). Rectal inserts and related accessories (A4337) will be denied as not reasonable and necessary because they do not meet the medical evidence requirements outlined in the CMS Pub. 100-08, Medicare Program Integrity Manual (PIM), Chapter 13. Electrical continence aids are in the experimental stage of development and there is no valid scientific documentation of their effectiveness and safety; therefore, they are denied as not reasonable and necessary (see NCD 230.15 in the “Related National Coverage Documents” section of this LCD). Fecal collection systems and rectal catheters/tubes used with such systems will be denied as statutorily non-covered, no benefit (refer to the NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES section of the LCD-related Policy Article).
Excerpt from LCD L36267 version 44, effective 04/01/2026. CMS LCD L36267.
An electrical continence aid is a device consisting of a plastic plug, molded into the shape of the patient's anal canal, which contains two implanted electrodes that are connected by a wire to a small portable generator. An electrical current is produced which stimulates the anal musculature to cause a contraction sufficient to hold the plug in while allowing the patient to ambulate without incontinence.
Not Covered Electrical continence aids are in the experimental stage of development and there is no valid scientific documentation of their effectiveness and safety. Therefore, they are not covered under Medicare since they cannot be considered to be reasonable and necessary for the treatment of an illness or injury or to improve the functioning of a malformed body member as required by §1862(a)(1) of the Act.
Excerpt from NCD 230.15 version 1. CMS NCD 230.15.
Version 44. CMS effective date 04/01/2026. CMS updated 04/08/2026. Contractors on the CMS report: CGS Administrators (DME MAC) and Noridian Healthcare Solutions (DME MAC).
CMS coverage policy citation on the LCD. CMS Pub. 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Sections 230.15 and 280.1
Current version on the CMS national report: 1. Effective date This is a longstanding national coverage determination. The effective date of this version has not been posted.. Benefit category: Prosthetic Devices.
Current version on the CMS national report: 4. Effective date 06/09/2025. Benefit category: Durable Medical Equipment. The LCD lists related NCD version 1. The excerpt on this page, when present, is version 4.
In addition to policy specific documentation requirements, there are general documentation requirements that are applicable to all DMEPOS policies. These general requirements are located in the DOCUMENTATION REQUIREMENTS section of the LCD. Refer to the LCD-related Standard Documentation Requirements article, located at the bottom of this Policy Article under the Related Local Coverage Documents section for additional information regarding GENERAL DOCUMENTATION REQUIREMENTS and the POLICY SPECIFIC DOCUMENTATION REQUIREMENTS discussed below.
GENERAL There are numerous CMS manual requirements, reasonable and necessary (R&N) requirements, benefit category, and other statutory and regulatory requirements that must be met in order for payment to be justified. In the event of a claim review, a DMEPOS supplier must provide sufficient information to demonstrate that the applicable criteria have been met thus justifying payment. Before submitting a claim to Medicare, the DMEPOS supplier must have on file an SWO, a WOPD (if applicable), information from the treating practitioner concerning the patient's diagnosis, and any information required for the use of specific
The signed answer is the receipt for this code on a date of service: the rule that was in force, with a hash you can replay. The call needs an API key. The source archive and as-of resolution are public.
curl -H "X-API-Key: $VERZI_API_KEY" \
"https://api.verzi.health/v1/rules/warrant?hcpcs=E0275&as_of=2024-01-15&npi=1234567890&state=UT"The current DME MAC LCD L36267, Bowel Management Devices, version 44, effective 04/01/2026.
NCD 230.15, Electrical Continence Aid, version 1, is the current national document related from the LCD.
If the supplier bills for an item addressed in this policy without first receiving a completed SWO, the claim shall be denied as not reasonable and necessary.
Request a free API key and call the signed-answer endpoint with the HCPCS code, a date of service, the supplier NPI, and a state. The response is a receipt for the published rule on that date, not a guarantee of payment.