A new “Dear Physician” letter from the DME MACs aims to streamline the ordering process for positive airway pressure (PAP) and respiratory assist device (RAD) supplies.
The February letter reviews the elements required for Medicare PAP or RAD reimbursement. The Standard Written Order (SWO) elements required include the beneficiary’s name or Medicare Beneficiary Identifier; the order date; a general description of the item, such as a general description or a HCPCS code; the quantity to be dispensed; treating practitioner name or National Provider Identifier (NPI); and the treating practitioner’s signature.
New general description options
The DME MACs’ letter said that for the general description of the item, treating practitioners could list PAP or RAD therapy masks as CPAP mask, mask of choice, mask — fit to comfort, or mask — one per three months.
“Use of these general descriptions on the SWO, as opposed to a specific mask type (i.e., full face mask), will eliminate
the need for a new SWO each time a patient switches their mask type,” the letter said. “In situations where the mask type is specified on the SWO and the patient needs to change mask type, a new SWO would be required since this would be considered a change to the SWO.”
The letter also said the treating practitioner could include “multiple mask types on the SWO, so that DMEPOS suppliers are able to provide the mask that works best for the patient.”
In a Feb. 8 bulletin, the American Association for Homecare (AAHomecare) said about the letter, “This flexibility not only reduces administrative burdens, but also ensures patients receive the most suitable masks and supplies without delays. By streamlining paperwork, healthcare providers and DMEPOS suppliers can focus on patient care.”
AAHomecare also expressed appreciation to the DME MACs: “AAHomecare thanks the DME MAC Medical Directors for these guidelines to simplify the ordering process for PAP and RAD supplies. AAHomecare also would like to thank volunteer leadership from DME MAC Jurisdiction Councils and AAHomecare’s HME/RT Council and Regulatory Council, who have advocated for this change.”
