• Patient Lifts Info.

    CMS requires that for Specified Covered Items payment may only be made if a physician has communicated to the supplier a written order for the item before the de-livery of the item.

    For many items of DME, a physician must document that a physician, a physician as-sistant (PA), a nurse practitioner (NP), or a
    clinical nurse specialist (CNS) has had a face-to-face encounter with the beneficiary pursuant to that order. The encounter must
    occur during the six months prior to the written order for each item.

    The patient’s medical record must con-tain sufficient documentation of the pa-tient’s medical condition to substantiate the necessity for the type and quantity of items ordered and must be signed by the or-dering physician.


    Documentation Requirements

    •  Duration of patient’s condition
    •  Clinical course ❑ Prognosis
    • Nature and extent of functional limitations
    • Other Therapeutic interventions and results Key Items to Address
    • Why does the patient require the item?
    • Do the physical examination find-ings support the need for the item?
    •  Signs and symptoms that indicate the need for the item.
    •  Diagnoses that are responsible for these signs and symptoms.
    •  Other diagnoses that may relate to the need for the item.


    Documentation Tips

    •  The information must not be re-corded in vague and subjective terms.
    • The information must provide ob-jective measures, tests or observa-tions.
    •  Each medical record is expected to be individualized to the unique patient.

    Coverage Criteria Specific to Patient Lifts

    A patient lift is covered if transfer between bed and chair, wheelchair, or commode is required and, without the use of a lift, the patient would be bed confined and so documented in the patient’s medical record.

    A multi-positional patient transfer system is covered if both of the follow-ing criteria are met and documented in the patient’s medical record:

    •  The basic coverage criteria (above) for a lift are met; and
    •  The patient requires supine positioning for transfers.