Unassigned Claims Denied on the Basis of Not Being

150.1.2 - Unassigned Claims Denied on the Basis of Not Being Reasonable and Necessary (Rev. 1, 10-01-03) For unassigned claims denied on the basis of not being reasonable and necessary under §1862(a)(1) of the Act; or Medicare payment being denied in advance under §1834(a)(15) of the Act; the term “medical equipment and supplies” means: • Durable medical equipment, as defined in §1861(n) of the Act; • Prosthetic devices, as described in §1861(s)(8) of the Act; • Orthotics and prosthetics, as described in §1861(s)(9) of the Act; • Surgical dressings, as described in §1861(s)(5) of the Act; and • Such other items as the Secretary may determine.