Article Detail - JD DME

Noridian receives many questions regarding elements required on the Standard Written Order (SWO). The requirements are listed in the Standard Documentation Requirements Policy Article - A55426.

The Importance of Standard Written Orders

A SWO is an important document in the reimbursement process for DMEPOS items. The SWO must be on file before the claim is submitted to Medicare to ensure compliance with Medicare regulations. All items billed to Medicare for payment require an SWO. For certain DMEPOS items, a Written Order Prior to Delivery (WOPD) is necessary. This means that the SWO must be completed and on file to the DMEPOS supplier before delivery of the items to the beneficiary.

Required Elements of an SWO:

To ensure compliance and facilitate the reimbursement process, the following elements must be included in a Standard Written Order:

1. Beneficiary's Name or Medicare Beneficiary Identifier (MBI): This identifies the individual who will be receiving the DMEPOS item.
2. Order Date: The order date is the date the practitioner orders the item and can be any time prior to or on the date of service (date of delivery) of the item to the beneficiary.
3. General Description of the Item:
   • This can be a general term (e.g., wheelchair, hospital bed), a specific Healthcare Common Procedure Coding System (HCPCS) code, a narrative description, or a brand name/model number.
   • For equipment, the SWO should detail the base item along with any concurrently ordered options, accessories, or additional features that are separately billed or require an upgraded code.
   • For supplies, the order may also include all concurrently ordered items that are separately billed.
4. Quantity to be Dispensed (if applicable): This specifies how many units of the item are being ordered.
5. Treating Practitioner Name or National Provider Identifier (NPI): The name or NPI of the practitioner who is prescribing the item must be included.
6. Treating Practitioner's Signature: A signature from the treating practitioner is necessary to validate the order.

While the above elements are mandatory, it's important to note that the length of need, frequency of use, settings, diagnosis, or other elements, are not required on the SWO, but may be beneficial to include. Everything included on the order must be substantiated and documented in the beneficiary's medical record if required to meet the medical necessity requirements for the item.