- Physicians: Are You Ordering External Breast Prostheses for Your Patient?
- Physicians: Are You Ordering Surgical Dressings for Your Patient?
- Practitioners: Are You Ordering Nebulizers and Inhalation Medication for Your Patient?
- Physicians: Are You Ordering Glucose Monitors and Supplies for Your Patients?
- Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
- DME CERT Physician's Corner
- Physicians: Are You Ordering PAP Devices and Related Accessories for Your Patients?
- Practitioners: Are You Ordering Spinal Orthoses for Your Patient?
- Practitioners: Are You Ordering Ankle-Foot/Knee-Ankle-Foot Orthoses for Your Patients?
- Clinicians: Are You Ordering Oxygen for Your Patient?
- Clinicians: Are You Ordering Diabetic Shoes for Your Patients?
- Physicians Ordering Oxygen and Oxygen Equipment - Quick Tips
- Practitioners: Are You Ordering Knee Orthoses for Your Patients?
- 2024 DMEPOS HCPCS Jurisdiction Listing
- Physicians: Are You Ordering DMEPOS for Your Patients?
Physicians: Are You Ordering DMEPOS for Your Patients?
Physicians provide the foundation for correctly billing services and/or supplies to Medicare. DMEPOS suppliers rely on prescribing providers to substantiate the need for services and/or supplies billed to the Medicare program.
Table of Contents
Medical Records
Medical records should be complete, legible, and include the following information:
- Reason for encounter, relevant history, physical exam findings, test results and date of service
- Assessment and impression of diagnosis
- Plan of care with date and legible signature
- Documentation that supports that the rendering/billing provider indicated on claim is the healthcare professional providing the service
- Records should not only substantiate service performed but also required level of care
Documentation Requirements
- SWO/prescription (not considered part of medical record)
- Exception to SWO – prescribing practitioners who are also suppliers
SWO elements may be listed in medical record
- Exception to SWO – prescribing practitioners who are also suppliers
- WOPD for items on the CMS required list (can serve as SWO)
- F2F encounter
For DMEPOS items on the required F2F and WOPD list, the treating practitioner documents and communicates that the F2F occurred within six months prior to the WOPD (unless superseded by the LCD and related policy article) to the supplier.
Who Can Complete a SWO?
Power Mobility Devices
- Treating practitioner who conducts qualifying F2F prepares SWO for PMD base
All DMEPOS items except PMDs
- Certain elements of order may be completed by someone other than the treating practitioner
- Treating practitioner identified in order must sign the document
Related Content
- Centers for Medicare & Medicaid Services Internet-Only Manual Publication 100-08, Program Integrity Manual, Chapter 5
- eCFR :: 42 CFR Part 414 Subpart B -- Physicians and Other Practitioners
- eCFR :: 42 CFR 410.78 -- Telehealth services
- Code of Federal Regulations
- Article - Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426)
Revised 2/21/2024