Article Detail - JD DME
Urological Supplies and Continued Medical Need
For all DMEPOS items, the initial justification for medical necessity is determined when the item is first prescribed. Beneficiary medical records confirming the item’s reasonableness and necessity are created immediately before or at the time of the initial prescription.
Once medical necessity is established, ongoing need for urological supplies is presumed for beneficiaries with permanent urinary incontinence or retention, unless continued coverage requirements are outlined in the LCD. If the beneficiary continues to qualify under the Prosthetic Devices benefit, no further documentation of continued medical need is required.
For additional details on surgical dressings, refer to Local Coverage Determination (LCD) L33803 and Policy Article A52521 available on the Noridian Urological Supplies webpage.
