Documentation for Ostomy Supplies

by  Medicare Learning Network
March 8th, 2018

The Medicare Learning Network provides guidance on essential documentation elements required to prevent denials for ostomy supplies:

To Prevent Denials
Include the following elements in submitted documentation:
1. Dispensing order description of the item
  • Beneficiary name
  • Prescribing physician name
  • Date of the order and the start date, if the start date is different from the date of the order
  • Physician signature (if a written order) or supplier signature (if verbal)
2. Detailed Written Order (DWO)
  • Beneficiary name
  • Physician name
  • Date of the order and the start date, if start date is different from the date of the order
  • Detailed description of the item(s)
  • Physician signature and signature date

3. Beneficiary Authorization

4. Refill Requirements
  • A routine refill prescription is not needed; a new prescription is needed when:
    • There is a change of supplier
    • There is a change in the item(s), frequency of use, or amount prescribed
    • There is a change in the length of need or a previously established length of need expires (state law requires a prescription renewal)
5. Proof of Delivery (POD) 
  • Suppliers are required to maintain POD documentation in their files
6. Evidence of continued medical need
  • Initial justification for the medical need is established at the time the item(s) are first ordered
7. Evidence of continued use
  • Continued use describes the ongoing utilization of supplies or a rental item by a beneficiary
The following reminders will help you comply with Medicare ostomy supply coverage requirements:
  1. Medical records must contain adequate, clear documentation that corroborates the medical necessity of the amount ordered and billed.
  2. Ostomy supplies are not separately payable when a beneficiary is in a covered home health episode. The home health agency must provide the ostomy supplies, and payment is included in the home health Medicare payment rate.


Documentation for Ostomy Supplies. (2018, March 8). Find-A-Code Articles. Retrieved from

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