How to comply with rapid PWC changes

Wednesday, November 30, 2005

Q. PMD documentation is one of the biggest questions for suppliers. When does the face-to-face requirement take effect? How do I educate my physician referral sources?
A. The face-to-face examination requirement went into effect on Oct. 25. However, on Oct. 26, Sen. Arlen Specter, R-Pa., proposed an amendment that would delay implementation until April 1, 2006. This was due, in large part, to the lack of time to educate all interested parties. The bill will need to pass through the House and get a signature by the president, which is expected by Thanksgiving.
Several manufacturers have put together a "Functional Mobility Evaluation" form to assist providers in educating their referral sources. The form is based on the algorithmic process described in the national coverage determination (NCD), which was effective May 5. It provides the information necessary for the physician or treating practitioner to qualify a beneficiary for the appropriate type of mobility equipment to meet their needs. It does not replace the need to have pertinent information from the patient's medical records, but it provides guidance for what should be documented. The prescription must include:
Beneficiary's name;
Description of item ordered;
Date of face-to-face examination;
Pertinent diagnoses/conditions that relate to the need for a PMD;
Length of need;
Physician's signature; and
Date prescription is signed
The prescription and copies of the pertinent medical records must be received by the supplier within 30 days of the face-to-face exam and prior to dispensing any equipment. The CMN is no longer required for review, completion or signature by the physician, but a partially completed CMN from the supplier is still necessary. Instructions can be found at

Jim Stephenson is a rehab reimbursement specialist for Invacare. Reach him at (800) 333-6900 or

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