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Linda Collins Blogger

DWO = Detailed Written Orders

Posted by Linda Collins | June 07, 2016

The Centers for Medicare & Medicaid Services requires a Detailed Written Order for all DMEPOs claims. Upon request, you are required to submit a copy of the complete and accurate DWO in order to support payment of the claim. However, published Medicare Administrative Contractor claim results continue to reveal that suppliers fail to comply with these requirements. 

What does this mean for you? 

You have to follow the rules - no ifs, ands or buts. The Program Integrity Manual, Chapter 5, outlines the 4 main DWO requirements:

*Medicare requires an order for every item (except repairs) of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Detailed written orders must not be used to add unrelated items, whether requested by the beneficiary or not, in the absence of a dispensing order from the physician for that item.

Example: The physician has given a dispensing order for lower limb prosthesis. The supplier may not add an AFO/KAFO for the  to the order. The brace is not related to the item requested in the original order.

*A DWO must include the patient’s name, item ordered, the prescriber’s national provider identifier and signature along with the date of the order. An order without these minimum elements will be considered incomplete and will not support claim payment.

Example: After receiving the dispensing order, and thoroughly evaluating the patient, the Prosthetist can create a DWO that includes all these necessary elements and send it back to the physician for signature and date.

*Someone other than the physician may create the DWO. However, the treating physician must review the detailed description and personally sign and date the order to indicate agreement.

Example: Practitioners may use templates for their detailed written orders that include a listing of the specific items being provided for the individual beneficiary. In this case, the final document that is signed and dated by the physician must clearly identify the specific items that are being ordered for that particular patient.

*Medical necessity information (e.g., an ICD-9-CM diagnosis code, narrative description of the patient's condition, abilities, and limitations) is NOT in itself considered to be part of the order although it may be put on the same document as the order. The DWO is not considered part of the patient’s medical record so it will NOT meet the requirements of corroborating documentation.

Example: The prosthetist creates a DWO which includes a narrative on the patient’s past prosthetic use, expected functional level and desire to ambulate. The prosthetist is required to gather other physician notes/reports that support this assessment.

Refer to the Supplier Manual and the LCDs for additional information about order requirements.

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