Detailed Written Order (DWO) Requirements
Policy effective July 1, 2013
DWOPD enforceable as of January 1, 2014
Medicare implemented new requirements stating a face to face encounter as well as a DWO be obtained prior to dispensing certain DME items effective July 1, 2013. Failure to meet these requirements will result in non-payment from Medicare and patient financial responsibility.
DOCUMENTATION REQUIREMENTS:
- It must be documented that a physician, PA, NP, or CNS has had a face to face encounter examination with the patient in the 6 months prior to the DWO. All documented encounters must have appropriate facility and patient identifiers, be dated, and all signatures must meet Medicare requirements. Additionally, a face to face encounter cannot happen after an order for DME is written.
- The face to face must document that the patient was evaluated and/or treated for a condition that supports the need for the DME ordered. The plan of care should clearly identify the item ordered.
DETAILED WRITTEN ORDER REQUIREMENTS:
- The DWO must include the following:
- Patient name
- Date of the order
- Description of each DME ordered
- The length of need
- Route of administration/dosage when applicable (ex: 2 LPM O2 continuous via NC)
- The prescribing practitioner’s NPI
- The signature and signature date of the ordering practitioner
OUR AFFECTED HCPC’S:
| E0185 | gel pressure mattress pad |
| E0250 | fixed height hospital bed |
| E0260 | semi-electric hospital bed |
| E0261 | semi-electric hospital bed without mattress |
| E0265 | fully electric hospital bed |
| E0301 | heavy duty hospital bed weight capacity 350-600 lbs. without mattress |
| E0302 | heavy duty hospital bed weight capacity greater than 600 lbs. without mattress |
| E0303 | heavy duty hospital bed weight capacity 350-600 lbs. with mattress |
| E0431 | portable gas oxygen system |
| E0424 | stationary compressed gas system |
| E0434 | portable liquid oxygen system |
| E0439 | stationary liquid system |
| E0442 | stationary liquid contents |
| E0443 | portable gas oxygen contents |
| E0444 | portable liquid oxygen contents |
| E0450 | volume control ventilator without pressure support |
| E0461 | volume control ventilator without pressure support – noninvasive |
| E0463 | pressure support ventilator with volume control |
| E0464 | pressure support vent with volume control – noninvasive |
| E0470 | respiratory assist device bi-level pressure |
| E0471 | respiratory assist device bi-level pressure with back up rate |
| E0480 | precursor electric/pneumatic home model |
| E0482 | cough stimulating device |
| E0484 | oscillatory positive expiratory device, non-electric (Acapella) |
| E0570 | nebulizer with compressor |
| E0575 | nebulizer, ultrasonic, large volume |
| E0580 | nebulizer, durable, glass or autoclavable plastic, bottle type used with regulator or flowmeter |
| E0585 | nebulizer with compressor and heater |
| E0601 | continuous airway pressure device |
| E1031 | roll about chair |
| E1038 | transport wheelchair |
| K0001-K0009 | manual wheelchair bases |
Please take note that portable oxygen as well as refills are on this list (refills are billed between month 37 and 60); orders must list all the equipment: oxygen @ 2 LPM continuous via NC with portability/refills.