It's important for both physicians and patients to understand the documentation requirements for ordering Durable Medical Equipment. These requirements have become more stringent, resulting in an increase in claim denials. If a claim is denied, the patient may have to assume financial responsibility or return the equipment to the supplier.
Our goal is to help physicians better understand the documentation requirements to ensure patients get the equipment and services they need. The following information should be documented in the patient’s medical record prior to ordering durable medical equipment:
- Duration of patient’s condition
- Clinical course
- Prognosis
- Nature and extent of functional limitations
- Other therapeutic interventions and results
The following items should also be addressed in the patient’s medical record:
- Why does the patient require the item?
- Do the physical examination findings support the need for the item?
- Signs and symptoms that indicate the need for the item
- Diagnoses that are responsible for the signs and symptoms
- Other diagnoses that may relate to the need for the item
If you have any questions regarding these requirements, please contact Pro2 at 716-667-9600.
Here are some things to keep in mind this winter season:
- If you're on home oxygen, make sure you know how to operate your back-up “E” cylinder in case there is a power outage. If you have any questions about this or can't remember how to operate it, just give us a call!
- Do you have a back-up plan in place? You should! Power outages in this area can be widespread (as seen in the October Storm in 2006) or localized (think the blizzard just earlier this month). Be sure to make arrangements with friends and family members before a storm hits. Stay in touch with them via cell phone during the storm.
- If you do lose power call Pro2 to put us on alert. If you'll be out of power longer than your back-up supply will last, you'll need to get to a friend/family member's house that has power or an emergency shelter. It's important that you take your concentrator with you.
- While snow and cold temperatures present obstacles, as long as you're home with food, heat, and a back-up plan in place you can ride them out.
- Save your portable cylinders is case you have to leave your home for some unexpected reason.
Feel free to call us if you have any questions about this or have tips for others you would like to pass along.
Many patients are receiving new supplies for their PAP machine only to get those supplies home and discover the mask doesn’t seem to fit the tubing or the tubing doesn’t fit the unit!
This problem is occurring because manufacturers now make the masks with a quick disconnect. This is to allow you to leave the mask on should you need to get up in the middle of the night- to make a trip to the bathroom, for example.
However, when new supplies are introduced many forget that the quick disconnect is still stuck in the tubing. Both the tubing and this part are usually gray, which makes it appear as one unit. All masks and tubing have a universal fitting, so there should never be a problem with attaching the two together. The easiest way to remove this small part is to pretend you're breaking them apart and remove it at an angle.
If you're still having a problem please call our office and ask for the Respiratory Department. We're happy to help!