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January 2, 2020

Policy Article Revisions Summary for January 2, 2020

Outlined below are the principal changes to the DME MAC Policy Article (PA) that has been revised and posted. The policy included is Standard Documentation Requirements for All Claims Submitted to DME MACs. Please review the entire PA for complete information.

Standard Documentation Requirements for All Claims Submitted to DME MACs

PA

Standard Documentation Requirements for All Claims Submitted to DME MACsExternal Website

Revision Effective Date: 01/01/2020

PRESCRIPTION (ORDER) REQUIREMENTS:

  • Revised: Title to ORDERS
  • Revised: Language based on Final Rule 1713-F

NEW ORDER REQUIREMENTS:

  • Revised: Language based on Final Rule 1713-F

DISPENSING ORDERS:

  • Deleted: Entire section based on Final Rule 1713-F

DETAILED WRITTEN ORDER:

  • Revised: Title to STANDARD WRITTEN ORDER (SWO) based on Final Rule 1713-F
  • Revised: Language based on Final Rule 1713-F

WRITTEN ORDERS PRIOR TO DELIVERY (WOPD):

  • Revised: Language based on Final Rule 1713-F

POWER MOBILITY DEVICES WOPD (7 ELEMENT ORDER):

  • Deleted: Entire section based on Final Rule 1713-F

POWER MOBILITY DEVICES DETAILED PRODUCT DESCRIPTION:

  • Deleted: Entire section based on Final Rule 1713-F

WOPD FOR SPECIFIED DMEPOS ITEMS (5 ELEMENT ORDER):

  • Deleted: Entire section based on Final Rule 1713-F

DOCUMENTATION REQUIREMENTS:

  • Revised: Language based on Final Rule 1713-F

FACE-TO-FACE EXAMINATION FOR SPECIFIED DMEPOS ITEMS:

  • Revised: Title to FACE-TO-FACE ENCOUNTER
  • Revised: Language based on Final Rule 1713-F

FACE-TO-FACE REQUIREMENTS:

  • Deleted: Title of section

CERTIFICATE OF MEDICAL NECESSITY (CMN) & DME INFORMATION FORM (DIF):

  • Revised: Language based on Final Rule 1713-F

01/02/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.

Note: The information contained in this article is only a summary of revisions to the PA. For complete information on any topic, you must review the PA.

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