National Government Services (NGS), the Jurisdiction B DME MAC, has created documentation and coverage criteria checklists for a range of DME categories.
NGS checklists are now available for manual wheelchairs and power mobility devices, in addition to other DME in high demand by Medicare beneficiaries, such as glucose monitors, oxygen and oxygen equipment, and therapeutic shoes for patients with diabetes.
The manual chairs checklist is divided into six sections: Detailed Written Order, Medical Records, Addition(al) Criteria for Specific Wheelchairs, Proof of Delivery, Home Assessment, and Reminders.
Each section contains documentation-related notes to suppliers. For example, the Detailed Written Order section indicates supplier claims must include the beneficiary name, treating physician’s name, detailed description of the items to be provided, treating physician’s signature and date order signed, and start date of order, if the start date is different than the signature date.
In the Additional Criteria section, suppliers are reminded that if, for instance, the claim asks for a standard hemi-wheelchair, the claim must include documentation stating why a lower seat height is required – such as because the patient needs to propel with his feet, or is of short stature.
The checklists can be downloaded by going to ngsmedicare.com; clicking on “Go to Home Page” in the Jurisdiction B Suppliers/DME/All Locations box; and clicking on “Clinical Education” in the Education and Training box in the left column. When the Clinical Education page appears, click to download the checklists that are grouped by product category.
