Verbal orders, written orders - Detailed review

b. Verbal Orders:

1. Verbal orders from the prescribing physician/practitioner may be accepted for DMEPOS items that do not require prior authorization by the DHCFP (except when Medicare is primary and Medicaid copayment will be requested, and Medicare requires a written order for that item prior to delivery). Refer online to the DME MAC
Jurisdiction D Supplier Manual, Chapter 3 – Documentation Requirements, for a current listing of those items at:
https://www.noridianmedicare.com/dme/news/manual/chapter3.html

2. The verbal dispensing order must include:
a. A description of the item;
b. The recipient’s name;
c. The physician’s name;
d. The start date and length of need of the order; and
e. Additional information sufficient to allow appropriate dispensing of the item.

3. Suppliers must maintain written documentation of the verbal order and, if the verbal order is used for dispensing the item, the supplier must obtain a detailed written order prior to billing the DHCFP

c. Written Orders:

1. Written orders are acceptable for all transactions involving DMEPOS and must be obtained prior to submitting a prior authorization for any DMEPOS items. Written orders may take the form of a photocopy, facsimile image, electronically maintained, or original “pen-and-ink” document.

2. All written orders must, at a minimum:

a. Clearly specify the start date of the order;
b. Include the length of need;

c. Be sufficiently detailed, including all options or additional features that are needed to meet the recipient’s needs. The description must be either a narrative description (e.g., lightweight wheelchair base) or a brand name/model number; and

d. Be signed and dated by the treating physician/practitioner. Signature includes computer signature and pen and ink, no signature stamps allowed 3. Certain items require additional elements in the written orders, as follows:

a. If the written order is for supplies that will be provided on a periodic basis, the written order must include appropriate information on the quantity used, frequency of change, and duration of need. (For example, an order for surgical dressings might specify one 4x4-hydrocolloid dressing that is changed one to two times per week for one month or until the ulcer heals).

b. If the written order is for an item such as, but not limited to, enteral formula, oxygen, etc., the order must specify the name of the product, concentration (if applicable), dosage, frequency and route of administration, and duration of infusion (if applicable).

c. Custom-fabricated items must be clearly indicated on the written order that has been signed and dated by the prescribing physician/practitioner.

4. There are additional specifications for orders for certain items, such as, but not limited to, Power Mobility Devices (PMDs). Refer to Appendix B for details.

5. The detailed description of the item(s) may be completed by an employee of the ordering physician/practitioner; however, the prescriber must review the detailed description and personally indicate agreement by signing and dating the order.

6. Medical necessity information (such as an ICD-9 diagnosis code, narrative description of the recipient’s condition, abilities, and limitations) is not in itself considered to be part of the order although it may be put on the same document as the order

d. New Orders Are Required When:

1. There is a change in the order of a specific DMEPOS item;
2. There is a change in the resident’s condition that warrants a change in the order, a change in the treating physician/practitioner, or DMEPOS supplier;
3. An item is replaced for any reason; or
4. An ongoing unchanged order continues to be medically necessary one year after the original order (orders are only valid for up to one year, unless documented with a shorter length of time).