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Due to the high-profile image within Medicare motorized wheelchairs have achieved recently, now is the time to make sure you are one hundred and fifty percent compliant with your paperwork. By taking the time up front to assure you have gathered all of the necessary information for your files, and reviewing the information to confirm it will hold-up in the event of an audit, you can feel confident that you will first, provide the most appropriate equipment for your patient and second, meet all Medicare documentation requirements.
In order to maintain compliance with Medicare standards and documentation requirements, you must understand what documentation you need to obtain when providing a motorized wheelchair to a patient.
Power Wheelchair Self Audit Guide
 Physician's Order
Don't deliver a power wheelchair to a patient solely based upon a verbal order. Medicare requires you have the detailed written order and all supporting medical documentation before dispensing any power wheelchair.
Note: If you decide to deliver a power wheelchair before receiving all the required documentation, the wheelchair will be denied as non-covered.
Certificate of Medical Necessity:
A Certificate of Medical Necessity is not required as of April 1, 2006.
Supporting Medical Documentation
Supporting documentation for power wheelchairs takes the shape of the chart notes from the face to face examination, physician's progress notes, hospital records, nursing home records or records from other healthcare professionals (such as physical therapists and occupational therapists).
The face to face examination report is essential and must discuss the patient's condition and the reason the physician ordered the equipment. Key elements of the patient's condition that should be discussed are quantitative measurements of strength in the extremities as well as the patient's ability to move around with their residence.
Although it is not required, the physician can order a physical therapist or occupational therapist mobility evaluation. This evaluation outlines Medicare's supporting documentation requirements such as the patient's functional capabilities, ambulatory status, strength measurements, cognitive abilities and an explanation why the item ordered is the only possible means for the patient to perform his or her activities of daily living (ruling out all less costly equipment alternatives).
If this is completed by the PT or OT, make sure to have the patient's physician review the evaluation and provide an annotation on the evaluation stating his concurrence with the evaluation.
The last piece of the medical necessity puzzle is an in-home evaluation of the patient and the patient's surroundings to determine if there are any obstacles (such as narrow doorways or hallways) in the home that will interfere with safe use.
With all the above documents on hand, you can rest assured that you took all the necessary steps to supply the patient with the most appropriate equipment.
But don't neglect these few other items that auditors will look for in the beneficiary's chart after the equipment has been delivered.0
Delivery ticket
Be sure all of you delivery tickets are signed and dated by the beneficiary or an authorized representative. Your delivery ticket also should include your address and telephone number, the manufacturer's number, serial number and model name or number for equipment supplied, quantity supplied and again the beneficiary's signature and date.
Rent/Purchase option letter
This letter proves that you have given the beneficiary the option to either rent or purchase the equipment at the beginning of service or during the 10th month. |
