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CGS Administrators, LLC

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November 16, 2018 - Revised: February 2020

Top Reasons for Condition of Payment Prior Authorization Power Mobility Device Non-Affirmative Decisions

The following are the top non-affirmative decision reasons for the Condition of Payment Prior Authorization for CGS DME MAC Jurisdictions B and C, including information and resources to decrease the non-affirmative decisions.

Written Order Prior to Delivery (WOPD) and Face-to-Face

Standard Written Order (SWO) (for accessories)

Documentation Requirements

Additional Resources:

Local Coverage Determination and Policy Articles

Medical Review Resources for Power Mobility Devices:

Condition of Payment Prior Authorization:

Physician Resources

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