DMEPOS Orders

3.3.2.1.2 –DMEPOS Orders (Rev. 10190; Issued: 06-19-2020, Effective: 01-01-2020; Implementation: 07-01- 2020) Totality of the Record All DMEPOS items require a Standard Written Order (SWO) from the treating practitioner as a condition of payment. Medicare contractors shall consider the totality of the medical record when reviewing for compliance of the SWO elements. This will allow contractors to account for the dynamic nature of electronic medical record documentation systems, and give them additional discretion when they believe the entirety of the record demonstrates compliance with our order requirements. For example, a contractor may nonetheless support payment when an order has a missing or flawed element that is clearly documented elsewhere in the record. Contractors acting as a secondary reviewer shall grant deference to the initial reviewer’s discretion, if such an initial decision resulted in a reasonably prudent decision that aligns with Medicare coverage and coding instructions.