Prescription (order) Requirements

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
November 24th, 2015

Prescription (order) Requirements face-to-face examination is required each time a new prescription for one of the specified items is ordered. A new prescription is required by Medicare:

• For all claims for purchases or initial rentals
• When there is a change in the prescription for the accessory, supply, drug, etc.
• If a local coverage determination (LCD) requires periodic prescription renewal (i.e., policy requires a new prescription on a scheduled or periodic basis)
• When an item is replaced
• When there is a change in the supplier

These specified items require a written order that must be obtained prior to delivery (WOPD). A WOPD is a standard Medicare detailed written order, which must be completed and in the DMEPOS supplier’s possession BEFORE the item is delivered.

The prescription (order) for the DME must include all of the items below:

• Beneficiary’s name

• Physician’s 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

• The prescribing practitioner’s National Provider Identifier (NPI),

• The signature of the ordering practitioner

Signature date For any of the specified items provided on a periodic basis, including drugs, the written order must include:

• Item(s) to be dispensed

• Dosage or concentration, if applicable

• Route of Administration, if applicable

• Frequency of use

• Duration of infusion, if applicable

• Quantity to be dispensed

• Number of refills, if applicable

References:

Prescription (order) Requirements. (2015, November 24). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/prescription-order-requirements-27965.html

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