Tip From The Trenches

Date Published: April 26 2013

When are DME providers responsible for PMD home assessment documentation?

In the case of a physician using to complete a PMD face-to-face evaluation, the last paragraph in the written documentation will state whether or not the physician has deferred the home assessment to be completed by the DME provider. If they have, it is the DME provider’s responsibility to complete the home assessment and include that documentation with the face-to-face evaluation and seven-element order that is submitted to Medicare for approval. If the home assessment documentation is not provided (and the physician has indicated that it is the responsibility of the DME provider to get it) the PMD request will be denied.

If a request for DME equipment is denied as a result of the missing home assessment documentation, DME providers when appropriate should send a rebuttal stating that the physician’s note indicates that the DME provider should complete a home assessment to determine the PMD maneuverability, and attach the completed home assessment documentation. It is also worthwhile noting in the rebuttal, if accurate, that "the PMD recommended for the patient can be maneuvered in all rooms of this patient’s home, as per home assessment documentation provided".

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