Gov’t affairs

Saturday, May 31, 2008

Q. Can a provider complete any part of the written order for a power wheelchair?

A. The short answer is ‘No.’ Having said that, there are a few items that bear mentioning. Medicare’s PMD policy requires a written order that contains seven distinct elements:

- Beneficiary’s name.
- Description of the item that is ordered. This may be general--for example: “power operated vehicle” or “power mobility device”--or may be more specific.
- Date of the face-to-face examination.
- Pertinent diagnoses/conditions that relate to the need for the power device.
- Length of need.
- Physician’s signature.
- Date of physician signature.

A date stamp or equivalent must be used to document the receipt date and the provider has 45 days from the date of the face-to-face examination to obtain this order. If not, an EY modifier must be added to the HCPCS codes for the mobility device and all accessories. The order must be available on request.

Providers can encounter situations in their everyday practices that ordinarily may be acceptable for some products and insurers, but not for Medicare. One example is a verbal order. A supplier cannot draft a form or template based on a verbal order for the physician to date and sign.

The physician must write, sign and date the seven-element order. The supplier can draft instructions about the requirements for the order or provide the physician with a form that contains spaces for the seven required elements. The spaces, however, must be left blank and no provider-specific information can be included on the form. It cannot be on company letterhead.

Paul Komishock is general manager of government affairs for Pride Mobility Products in Exeter, Pa. R