June 2017
CMS has very specific documentation requirements that apply to typical off-the-shelf and custom orthotics and other “DME” supplied by orthopaedic groups and hand therapy practices. DME carriers are auditing claims and specifically requesting this documentation.
Whenever a Medicare provider supplies and bills for DMEPOS, the documentation must include the following detailed written order and proof of delivery-which must be retained for at least seven years.
->Detailed Written Order. You must generate the “DWO” prior to submitting the claim and it must include:
• Patient name
• Physician name
• Date of order
• Detailed description of item(s) (i.e., narrative description or brand name/model #)
• Physician signature and signature date (can be electronic, but not a stamp)
(A PA can provide and sign the order if he or she is fully licensed, practicing under physician supervision per state law, and has a NPI.)
->Proof of Delivery. The “POD” must include:
• Patient name
• Delivery address
• Detailed description of item(s) (i.e., narrative description or brand name/model #)
• Quantity delivered
• Date received by patient
• Patient/designee signature and printed name (if designee signs, relationship should be noted)
The source of these requirements can be found in Chapter 3 of your DME carrier’s supplier manual. For example, see https://www.cgsmedicare.com/jc/pubs/pdf/chpt3.pdf.
PT Compensation
