PMD documentation: Physicians put on notice

Sunday, November 18, 2007

WASHINGTON - After requests from the rehab industry, the DME Medicare Administrative Contractors (MACs) posted letters to their Web sites last week that providers can download and send to physicians, reminding them of their documentation duties.

The one-page letters describe the documentation that must be included in physician medical records, including patient diagnosis and prognosis. It also puts physicians on notice: "Your cooperation is a legal requirement as outlined in the Social Security Act."

"Although our list of documentation issues is long, this is a step in the right direction," said Cara Bachenheimer, senior vice president of government relations for Invacare. "This is something that providers can send to physicians to egg them on. They're still having a horrible time getting documentation."

In 2005, CMS replaced CMNs with prescriptions and physician notes for power mobility devices. Two years later, however, providers still report only 9% of physicians "fully understand" the requirements, according to a recent survey by NCART. The result: The requirements have increased the education and paperwork burdens on providers, and delayed their ability to deliver PMDs.

The letters also notify physicians that providers will not receive payment from Medicare if they don't provide documentation from medical records when providers request it.

"Help your DMEPOS suppliers continue to provide good service to your patients," the letters say in closing.

While providers welcomed the letters and plan to use them, Rick Perrotta wonders how much of a difference they will make.

"Yes, it's a good thing, but how effective will it be when you have doctors who are responsive and doctors whose teeth you have to pull," said Perrotta, president of Network Medical Supply. "Unless there's some additional follow-up (from CMS), I think providers are still going to have a heck of a time getting proper documentation."