Karen This is so unfair! You shared <<The breast pump does not qualify as durable medical equipment eligible for reimbursement as it does not meet criteria #4 in the above definition. The breast pump can be useful to a person in absence of sickness or injury. There is the right to a further appeal of this determination. To do so, please submit Clinical documentation to substatiate the above noted criteriea for durable medical equipment has been met.>> My 10 yr old son and I have been wracking our brains trying to get around this loophole. We have been trying to think of another durable med equipment [DME] that would be reimbursed but did not meet the criteria. Surely there have been some exceptions. I would try to take this tack: Although DME is GENERALLY not usefull to a person who unless ill or injured, sometimes the DME may be useful during times of wellness. I would say that FOR THIS CLIENT, the pump will not be useful during the times of wellness [i.e. when the baby is fully recovered]. Maybe they cover an item such as a humidifier, which could be useful to someone when the air was dry. And maybe say something like a breastpump is only really needed during an altered state of wellness which would include extended mother baby separation such as a working mom, so you can not think of a time when a breastpump would really be absolutely needed in times of wellness. I know I am not making much sense, but this is a "riddle" that really is driving me crazy. Then again, here is a good case for them to rewrite their criteria for covering DME. AAAARRRRGGGHHH! Laurie Wheeler, RN, MN, IBCLC Violet Louisiana, s.e. USA ________________________________________________________________________ Get Your Private, Free E-mail from MSN Hotmail at http://www.hotmail.com *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html