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.
One of the following needs to be sufficiently documented to support the need for the prescribed equipment.
- Explain if the patient is confined to a single room or
- Explain if the patient is confined to one level of the home and there are no toilets on that level or
- Explain 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 CGSMedicare.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 letterhead 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.