Spinal Orthoses LCD P2

What You Need to Know:

The second part of the LCD is the General section. This covers three topics generally relevant to claims involving spinal orthoses:

1. Standard Written Order: The SWO must be complete (if a physician is dispensing) or in the supplier’s (O&P’s/DME’s) possession before submitting the claim.
2. Written Order Prior to Delivery: The WOPD must be complete (if a physician is dispensing) or in the supplier’s (O&P’s/DME’s) possession before delivering the spinal orthosis.
3. Proof of Delivery: You must retain proof of delivery and produce it when requested by a DME MAC or auditing contractor. Failure to produce a valid POD will result in a claim denial.
   

What This Means for You:

First, make sure that your Standard Written orders have all the elements in them required by Medicare. For a detailed description of those requirements, see our R&R post of Feb. 22, 2023. The SWO must be completed before claim submission.

Second, make sure that your Written Order Prior to Delivery has all of its required elements and is completed before delivering a spinal orthosis to your patient. For a detailed description of WOPD requirements, see that same R&R post of Feb. 22, 2023.

Finally, don’t overlook your Proof of Delivery documentation. You are responsible for getting the patient’s/guardian’s signature acknowledging that they received the spinal orthosis you delivered on the correct delivery date. For detailed information about POD’s, see our R&R post of March 15, 2023.

Next in this series: the Spinal Orthoses Policy Article.