DME suppliers may use these letters to assist in gathering documentation from clinicians.

• Blood Glucose Strips and Lancets [PDF]
• CERT Enteral Nutrition [PDF]
• Completion of Certifications of Medical Necessity - Annual Reminder [PDF]
• Continued Medical Necessity [PDF]
• Continuous Glucose Monitors [PDF]
• Continued Use [PDF]
• Documentation of Artificial Limbs and Braces [PDF]
• Electronic Health Records and Addenda [PDF]
• Face-to-Face and Written Order Requirements for Certain Types of DME [PDF]
• Glucose Monitors and Supplies [PDF]
• Home Oxygen Initial Qualification Testing [PDF]
• Immunosuppressive Drugs [PDF]
• Insulin for Insulin Infusion Pumps [PDF]
• Intermittent Urinary Catheterization [PDF]
• Knee Orthoses [PDF]
• Medical Records [PDF]
• Nebulizer [PDF]
• Negative Pressure Wound Therapy (NPWT) Pump [PDF]
• Oxygen and Oxygen Equipment [PDF]
• Patient Documentation Form - Insulin Using [PDF]
• Patient Documentation Form - Non-Insulin Using [PDF]
• PECOS [PDF]
• Positive Airway Pressure (PAP) Devices [PDF]
• Positive Airway Pressure (PAP) Devices Replacement [PDF]
• Positive Airway Pressure (PAP) Devices - Clinician Frequently Asked Questions [PDF]
• Power Wheelchairs (PWC) / Power Operated Vehicle (POV) [PDF]
• Prior Authorization Condition of Payment for Certain Power Mobility Devices [PDF]
• Respiratory Assist Devices (RAD) for Central Sleep Apnea or Complex Sleep Apnea [PDF]
• Respiratory Assist Devices (RAD) for Chronic Obstructive Pulmonary Disease (COPD) [PDF]
• Respiratory Assist Devices (RAD) for Hypoventilation Syndrome [PDF]
• Respiratory Assist Devices (RAD) for Restrictive Thoracic Disorders [PDF]
• Signature Authentication Tips [PDF]
• Therapeutic Shoes [PDF]

 

Retired Letters

• Artificial Limbs [PDF] Retired