DME MAC DMEPOS
DOCUMENTATION REQUIREMENTS
For any DMEPOS item to be covered by Medicare, the patient's medical record must contain sufficient information about the patient's medical condition to substantiate the necessity for the type and quantity of items ordered and for the frequency of use or replacement (if applicable).
The information should include the patient's diagnosis and the following information, as applicable:
- Duration of the patient's condition
- Clinical course (worsening or improvement)
- How patient will benefit from custom fabrication and goals with orthosis
- Prognosis, nature, and extent of functional limitation
- Other therapeutic interventions, and results
- Past experience with related items, etc.
The information should include the patient's diagnosis and the following information, as applicable:
- Duration of the patient's condition
- Clinical course (worsening or improvement)
- How patient will benefit from custom fabrication and goals with orthosis
- Prognosis, nature, and extent of functional limitation
- Other therapeutic interventions, and results
- Past experience with related items, etc.
