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External Infusion Pumps



Document Type Description
CMS 10125 DIF [PDF] External Infusion Pump DME Information Form (DIF)
Documentation Checklist [PDF] Suppliers may use this checklist to ensure all required documentation is gathered
Physician Letter - Medical Records [PDF] This letter may be sent to physicians to assist in obtaining documentation



Review Type Description
Medical Review View notifications and findings of pre and post claim reviews completed by Noridian Medical Review Staff


Topic Reminder
Drugs Used With External Infusion Pumps Coverage of drugs used with external infusion pumps may have differing denials. It is important for suppliers of these drugs to understand the issues related to coverage and denials.


Last Updated Nov 15, 2017

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