Medicare Claims Processing Manual (Pub. 100-04), Ch. 30 § 150.5.2.3
When a Request for an Advance Determination of Coverage
150.5.2.3 - When a Request for an Advance Determination of Coverage
Is Optional
(Rev. 1, 10-01-03)
A request for an advance determination of coverage of medical equipment and supplies is
optional under §1834(a)(15)(C)(iii) of the Act when the item is a customized item (other
than inexpensive items specified by the Secretary) and the patient to whom the item is to
be furnished or the supplier requests an advance determination.