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Standard Documentation Requirements for All Claims Submitted to DME MACs
Article A55426 · 21 versions, 2017 to today · last changed 2024-01-01 (R28)
Version 50 of Article A55426: in force by CMS's dates 2018-08-28 to 2018-12-31. The policy text on this page comes from this archived version.
JA · Noridian 16013
JB · CGS 17013
JC · CGS 18003
JD · Noridian 19003
source
CMS's Who are the MACs jurisdiction pages (DME facts as of 2025-09-30) name each contractor and its states; the MCD's Contractor Information table on every DME LCD prints the contract numbers. Both read 2026-10-09. Verzi adds the state lookup only.
Sections in this version: Article Text · Coding Information. Plus 1 section marked N/A in this version.
Full verbatim text serves to customers · Customer? Log in
Version history, Article A55426
CMS numbers each version. Each box shows the version's window by CMS's stated dates. Select a version to show it on this page. Versions superseded the same day they took effect never governed a claim, so the page hides them until you ask. Version numbers CMS never published to its archive do not exist as documents.
Revision history, every version
CMS's own change log, quoted, 20 entries. It does not change with the version shown. A revision (R-number) is a change CMS logged. The version (vN) is the snapshot that carries it.
R28 · 2024-01-01 · v132
Revision Effective Date: 01/01/2024 EQUIPMENT RETAINED FROM A PRIOR PAYER: Added: “Unless otherwise specified in an LCD or NCD, the original documentation (including but not limited to an original order and practitioner records) completed prior to the beneficiary entering FFS Medicare may be used to support that all Medicare requirements are met (such as the SWO, WOPD, and face-to-face encounter requirements). As a reminder, for items on the Required Face-to-Face Encounter and Written Order Prior to Delivery List, documentation used to satisfy the face-to-face encounter requirements must have been conducted within six months prior to the date on the WOPD.” as clarification 07/02/2026: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R19 · 2023-01-01 · v103
Revision Effective Date: 01/01/2023 ORDERS: Revised: Reference to “1861(r)(1)” which refers to physicians by removing “(1)” to reflect the full statutory definition of treating practitioner WRITTEN ORDERS PRIOR TO DELIVERY (WOPD) : Added: Statutory definition of treating practitioner for PMDs FACE-TO-FACE ENCOUNTER: Removed: “For example, the National Coverage Determination § 240.2 “Home use of Oxygen” requires a face-to-face examination within a month of starting home oxygen therapy.” (effective 09/27/2021) 06/15/2023: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R18 · 2023-01-01 · v98
Revision Effective Date: 01/01/2023 MEDICAL RECORD DOCUMENTATION: Added: “(for DOS prior to 01/01/2023)" after “CMN” Added: “prior to DOS 01/01/2023” in the second reminder bullet after “CMN” CONTINUED MEDICAL NEED: Added: "of supplies" to the end of the first bullet after "refills" Added: Bullet justifying continued medical need to include an order/prescription for repairs Added: “obtained prior to DOS 01/01/2023,” in the fourth bullet of items that justify continued need after “CMN or DIF” CERTIFICATE OF MEDICAL NECESSITY (CMN) & DME INFORMATION FORM (DIF): Added: Billing information relevant to CMNs and DIFs, for DOS affected by the CMN and DIF elimination REPLACEMENT: Added: “(prior to DOS 01/01/2023)” after "CMN" 11/24/2022: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R17 · 2020-04-06 · v91
Revision Effective Date: 04/06/2020 WRITTEN ORDERS PRIOR TO DELIVERY (WOPD): Added: “The current required Face-to-Face Encounter and Written Order Prior to Delivery List is available here.” with a hyperlink to the list 04/14/2022: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R16 · 2020-04-06 · v88
Revision Effective Date: 04/06/2020 MEDICAL RECORD DOCUMENTATION: Added: Statement regarding content of beneficiary’s medical record 02/03/2022: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination. This revision is non-substantive.
R15 · 2020-04-06 · v86
Revision Effective Date: 04/06/2020 DOCUMENTATION REQUIREMENTS: Added: Statement regarding exceptions to ongoing justification for continued medical need 12/30/2021: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination. This revision is non-substantive.
R14 · 2020-04-06 · v83
Revision Effective Date: 04/06/2020 STANDARD WRITTEN ORDER (SWO): Revised: Reference to the Medicare Program Integrity Manual from 'Internet only manual' to 'CMS Pub.' DOCUMENTATION REQUIREMENTS: Revised: “DME MAC supplier” to “DMEPOS supplier” in second paragraph CORRECT CODING: Revised: Reference to the Medicare Program Integrity Manual from 'Internet only manual' to 'CMS Pub.' Added: “45 CFR” in front of 162.1002 reference in first paragraph Revised: ‘Durable Medical Equipment Coding System’ reference to ‘DMECS’ to match the PDAC website REPAIRS/REPLACEMENT: Revised: References to the Medicare Benefit Policy Manual from 'Internet only manual' to 'CMS Pub.' SIGNATURE REQUIREMENTS: Revised: Reference to the Medicare Program Integrity Manual from 'Internet only manual' to 'CMS Pub.' 03/11/2021: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R13 · 2020-04-06 · v76
Revision Effective Date: 04/06/2020 REFILL DOCUMENTATION: Added: "REQUIREMENTS" to title PROOF OF DELIVERY (POD): Added: Prohibition for billing prior to discharge date 04/02/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R12 · 2020-01-01 · v72
Revision Effective Date: 01/01/2020 PRESCRIPTION (ORDER) REQUIREMENTS: Revised: Title to ORDERS Revised: Language based on Final Rule 1713-F NEW ORDER REQUIREMENTS: Revised: Language based on Final Rule 1713-F DISPENSING ORDERS: Deleted: Entire section based on Final Rule 1713-F DETAILED WRITTEN ORDER: Revised: Title to STANDARD WRITTEN ORDER (SWO) based on Final Rule 1713-F Revised: Language based on Final Rule 1713-F WRITTEN ORDERS PRIOR TO DELIVERY (WOPD): Revised: Language based on Final Rule 1713-F POWER MOBILITY DEVICES WOPD (7 ELEMENT ORDER): Deleted: Entire section based on Final Rule 1713-F POWER MOBILITY DEVICES DETAILED PRODUCT DESCRIPTION: Deleted: Entire section based on Final Rule 1713-F WOPD FOR SPECIFIED DMEPOS ITEMS (5 ELEMENT ORDER): Deleted: Entire section based on Final Rule 1713-F DOCUMENTATION REQUIREMENTS: Revised: Language based on Final Rule 1713-F FACE-TO-FACE EXAMINATION FOR SPECIFIED DMEPOS ITEMS: Revised: Title to FACE-TO-FACE ENCOUNTER R evised: Language based on Final Rule 1713-F FACE-TO-FACE REQUIREMENTS: Deleted: Title of section CERTIFICATE OF MEDICAL NECESSITY (CMN) & DME INFORMATION FORM (DIF): Revised: Language based on Final Rule 1713-F 01/02/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R11 · 2019-01-01 · v62
Revision Effective Date: 01/01/2019 DOCUMENTATION REQUIREMENTS: Added: Narrative section to clarify longstanding claims processing instructions Added: Date Span section to clarify longstanding claims processing instructions 08/08/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R10 · 2019-01-01 · v58
Revision Effective Date: 01/01/2019 ARTICLE TEXT: Removed: Last updated date POWER MOBILITY DEVICES WOPD (7 ELEMENT ORDER): Revised: 42 CFR 410.38(c) paragraph to remove the reference to HCPCS table PROOF OF DELIVERY (POD): Added: Postage paid delivery invoice option for POD documentation 04/04/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article that is not a local coverage determination.
R9 · 2019-01-01 · v55
Revision Effective Date: 01/01/2019 DETAILED WRITTEN ORDERS (DWO): Added: Exception to DWO when the prescribing practitioner is also the supplier PROOF OF DELIVERY (POD): Removed: Postage paid delivery invoice option from POD documentation CORRECT CODING: Removed: Link to PDAC Contact Form 01/31/2019: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. This revision is to an article and not a local coverage determination.
R8 · 2018-08-28 · v50
Revision Effective Date: 08/28/2018 PRESCRIPTION (ORDER) REQUIREMENTS Removed: Future start date language Revised: Elements of the DWO Removed: Prescribing physician's name from the DWO Removed: Additional order date instructions Added: Specific references to WOPD requirements Added: Practitioner to all physician references DOCUMENTATION REQUIREMENTS Clarified: Supplier documentation as it relates to specific products provided to beneficiary 08/23/2018: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.
R7 · 2018-05-07 · v41
Revision Effective Date: 05/07/2018 PRESCRIPTION (ORDER) REQUIREMENTS Correction: Corrected "nurse physician" to "nurse practitioner" WOPD FOR SPECIFIED DMEPOS ITEMS (5 ELEMENT ORDER) Correction: Corrected typo "SPECIFICIED" to "SPECIFIED" Clarified: Date of written order before date of delivery to include or shipped date PROOF OF DELIVERY (POD) Added: General Medicare DOS rule Added: Two options for DOS utilizing a shipping service REPLACEMENT Correction: Changed "cases" to "case" 05/03/2018: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.
R6 · 2017-12-21 · v38
Revision Effective Date: 12/21/2017 PROOF OF DELIVERY: Revised: Description of item being delivered 12/21/2017: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.
R5 · 2017-11-20 · v33
Revision Effective Date: 11/20/2017 DETAILED WRITTEN ORDERS: Revised: Description of all items ordered GENERAL: Added: Seven (7) year documentation retention direction PROOF OF DELIVERY: Revised: POD shipping date definition for Method 2 PROOF OF DELIVERY REQUIREMENTS FOR RECENTLY ELIGIBLE MEDICARE FFS: Revised: Supplier record information to an “and” from an “or” REPLACEMENT: Revised: updated word “entire” to “entirely” 11/16/2017: At this time 21st Century Cures Act applies to new and revised LCDs that restrict coverage, which require comment and notice. This revision is to an article that is not a local coverage determination.
R4 · 2017-06-01 · v26
Revision Effective Date: 06/01/2017 REFILL REQUIREMENTS: Revised: Deleted refill requirements that are policy specific and are currently located in the applicable LCDs
R3 · 2017-06-01 · v23
Revision Effective Date: 06/01/2017 PROOF OF DELIVERY: Revised: Corrects clerical error introduced with 01/01/2017 version. Language reverts to original three methods of delivery found in 04/28/16 version of SDL article.
R2 · 2017-05-25 · v17
Revision Effective Date: 05/25/17 WRITTEN ORDERS PRIOR TO DELIVERY (WOPD) Removed: Requirement for “Standard WOPD” for specific items identified by CMS or DME MACs such as Negative Pressure Wound Therapy (NPWT)
R1 · 2017-04-20 · v14
Revision Effective Date: 04/20/17 NEW ORDER REQUIREMENTS Revised: Change in supplier direction PROOF OF DELIVERY Revised: Proof of Delivery requirements and use of long description of the HCPCS code Previous Revisions 10/31/14; 11/05/15; 04/28/16; 01/01/17 Originally published 02/17/12
Receipts for auditors
Version 50 of Article A55426, shown on this page: in force by CMS's dates 2018-08-28 to 2018-12-31. Archived 2026-09-26. CMS's copy · Our archived file. 3 of 3 sections are proven word-identical to the archived file.
Every archived version of Article A55426 (29 versions, CMS's dates, window by the as-of rule).
| Document | Version | In force | Archived on | Verify |
|---|---|---|---|---|
| Article A55426 | version 12 | 2017-01-01 to 2017-04-19 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 14 | 2017-04-20 to 2017-05-24 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 17 | 2017-05-25 to 2017-05-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 23 | 2017-06-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 26 | 2017-06-01 to 2017-11-19 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 33 | 2017-11-20 to 2017-12-20 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 38 | 2017-12-21 to 2018-05-06 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 41 | 2018-05-07 to 2018-08-27 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 50 shown | 2018-08-28 to 2018-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 55 | 2019-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 58 | 2019-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 62 | 2019-01-01 to 2019-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 72 | 2020-01-01 to 2020-04-05 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 76 | 2020-04-06, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 83 | 2020-04-06, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 86 | 2020-04-06, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 88 | 2020-04-06, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 91 | 2020-04-06 to 2022-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 98 | 2023-01-01, superseded same day | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 103 | 2023-01-01 to 2023-12-31 | 2026-09-26 | CMS's copy · Our archived file |
| Article A55426 | version 107 no generated page | 2024-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A55426 | version 110 no generated page | 2024-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A55426 | version 113 no generated page | 2024-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A55426 | version 117 no generated page | 2024-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A55426 | version 120 no generated page | 2024-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A55426 | version 123 no generated page | 2024-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A55426 | version 128 no generated page | 2024-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A55426 | version 130 no generated page | 2024-01-01, superseded same day | 2026-10-09 | CMS's copy · Our archived file |
| Article A55426 | version 132 | 2024-01-01 to today | 2026-09-26 | CMS's copy · Our archived file |
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