Transcription of Supplier Manual - Chapter 3 Supplier Documentation
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Supplier Manual - Chapter 3 Supplier Documentation
Supplier Documentation Chapter 3 Winter 2018 DME MAC Jurisdiction C Supplier Manual Page 1 Chapter 3 Contents 1. General Information 2. Definition of Physician 3. Prescription (Order) Requirements 4. Documentation in the Patient s Medical Record 5. Signature Requirements 6. Refills of DMEPOS Items Provided on a Recurring Basis 7. Beneficiary Authorization 8. Proof of Delivery (POD) 9. Advance Beneficiary Notice (ABN) 10. Miscellaneous Documentation Issues 11. Evidence of Medical Necessity: Power Mobility Devices (PMD) 12. Comprehensive Error Rate Testing (CERT) 1. General Information CMS Manual System, Pub. 100-08, Medicare Program Integrity Manual , Chapter 5, For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements.
A WOPD is a completed SWO that is communicated to the DMEPOS supplier before delivery of the item(s). Pursuant to Final Rule 1713 (84 Fed. Reg Vol 217) and 42 CFR 410.38, CMS created the “Master List of DMEPOS Items Potentially Subject to Face-to-Face Encounter and Written Order Prior to Delivery and/or Prior Authorization Requirements.”
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