Required Elements of a SWO

5.2.2 - Required Elements of a SWO (Rev. 10190; Issued: 06-19-2020; Effective: 01-01-2020; Implementation: 07-01- 2020) A SWO must contain all of the following elements: • Beneficiary name or Medicare Beneficiary Identifier (MBI); • General description of the item. o The description can be either a general description (e.g., wheelchair or hospital bed), a brand name/model number, a HCPCS code, or a HCPCS code narrative; o For equipment – In addition to the description of the base item, the SWO may include all concurrently ordered options, accessories, or additional features that are separately billed or require an upgraded code (List each separately); o For supplies – In addition to the description of the base item, the SWO may include all concurrently ordered supplies that are separately billed Note: If such items are not concurrently ordered, they nonetheless require an order for payment purposes • Quantity to be dispensed, if applicable; • Order Date; • Treating Practitioner Name or National Provider Identifier (NPI); and • Treating Practitioner Signature. The elements of the SWO will be evaluated in accordance with Ch. 3, Section 3.3.2.1, which discusses using the totality of the record to verify compliance with required elements. Note also that while the SWO has a limited number of required order elements, suppliers/providers are permitted to add elements that may provide clarity for issues such as length of need (LON), frequency of use, dosage form/strength, refills frequency, etc. This additional information shall be corroborated by information in the medical record. Suppliers may also wish to consult state law or regulation since some states may have additional requirements for the elements of an order/prescription (e.g., refill frequency).