For all DMEPOS items, the initial justification for medical need is established at the time the item(s) is first ordered. Beneficiary medical records demonstrating that the item is reasonable and necessary are created just prior to, or at the time of, the creation of the initial prescription.

Once initial medical need is established, unless continued coverage requirements are specified in the LCD, ongoing need for urological supplies is assumed to drain or collect urine for a beneficiary who has permanent urinary incontinence or permanent urinary retention. There is no requirement for further documentation of continued medical need if the beneficiary continues to meet the Prosthetic Devices benefit.

Additional information on Surgical dressing can be found in the Local Coverage Determination (LCD) L33803 and Policy Article A52521 on the Noridian Urological Supplies webpage.