Commode Documentation Needs
The following qualification criteria need to be documented in the patients’ medical record notes to qualify for the prescribed equipment. Note: Justification notes are valid for six months.

The following need to be sufficiently documented to support the need for the prescribed equipment.
Standard commode

  • Explain why the patient cannot use the bathroom
  • Explain if the patient is confined to a single room or if the patient is confined to one level of the home and there are no toilets on that level or if the patient confined to the home and there are no toilet facilities in the home

Heavy Duty commode, document the above information and the following.

  • Document the patient’s weight.  Note: Patient must weigh 300lbs or more to qualify.

Drop arm commode, document the above information and the following.

  • If a Drop arm commode is needed explain why the patient needs this feature to facilitate transfers and/or explain if the patient has a body configuration that requires extra width?

Diagnosis: See LCD (Local coverage determination) at NGSMedicare.com for any additional qualifying information questions, diagnosis codes and descriptions

Medicare approved detailed equipment descriptions for commodes
Commode chair with fixed arms, (HCPC-E0163)
Commode chair, detachable/Drop arms, (HCPC-E0165)
Commode chair extra wide and or heavy duty with or without arms, (HCPC-E0168)

Patient notes/justification – Must be documented using your normal dictation process. Letter of medical necessity, notes wrote on letter head or prescriptions are not valid.

Prescription/order requirements – Must contain Patient’s name, date of the order and Start date, detailed equipment description (See above), signature of the ordering physician and a signature date.