What documentation is required to get equipment?

 
What documentation is required to get equipment?
 
Medicare has strict rules regarding what kind of documentation must be collected before an item can be ordered or covered for you. It is not necessarily up to you to remember, your provider has responsibility to help you understand. However, if there are items you choose to purchase, for example, before a prescription has been written by your doctor and submitted, then you will be responsible for paying for the item. The types of documentation include:
 

• Dispensing Orders - Many items can be ordered verbally by your doctor. A dispensing order requires the following information:
  • Description of the item
  • Name of beneficiary
  • Name of the physician
  • Start date of the order

• Written Orders (Prescription with Medical Justification) -For Medicare to reimburse for any item, they require a minimum of a detailed written order from the treating physician to be signed and dated before submitting a claim to Medicare. A detailed written order simply describes the order, gives information about the patient and supplier and most importantly, details the medical justification from the physician for the order. For rental items, the document must include the length of need. Certain supplies and drugs require additional information

• Written Orders Prior to Delivery (WOPD) - These are required for TENS units, seat lift mechanisms, decubitus care items, and negative pressure wound therapy. Most importantly, WOPDs are now required for mobility, most specifically power mobility devices (PMDs). The dates are critical here. The WOPD should be dated on or before the date the item was ordered.

• Certificates of Medical Necessity (CMNs) - There are 5 items that require CMNs, Home Therapy Oxygen, Lymphedema Pumps, Osteogenesis Stimulators, Transcutaneous Electrical Nerve Stimulators (TENS) Units, and Seat Lift Mechanisms

• DIFs DME MAC Information Form - The DIF is completed and signed by the supplier. It does not require a narrative description of equipment and cost or a physician signature. DIFs are used for Infusion Pumps and for Enteral Nutrition.

• Other documentation - there are several categories that require specific documentation: immunosuppressive drugs,support surfaces - groups 1 and 2 and respiratory assist devices (RADs)