Who is responsible for ensuring that the initial clinical evaluation and re-evaluation were conducted and who must retain documentation of that evaluation?
The treating physician is responsible for documenting the elements of the clinical evaluation and re-evaluation and must maintain that documentation as they would with any patient. Suppliers are responsible for ensuring that the coverage criteria have been met before applying the KX modifier to the code for PAP devices and accessories. Suppliers have the option of either requesting the information from the physician prior to dispensing the PAP device or waiting until requested to submit the information to the DME MAC. 2. Will phone-in compliance satisfy the requirement for demonstrating that the patient must be compliant with therapy for 4 or more hours a night for 70% of the nights in a consecutive 30-day period within the first 90 days of therapy? Answer: Yes, this is acceptable. The policy allows for either direct download or visual inspection of adherence information.
Related Questions
- Who is responsible for ensuring that employees submit accurate information on applications and supporting documentation? Is the information subject to review?
- Who is responsible for ensuring that the initial clinical evaluation and re-evaluation were conducted and who must retain documentation of that evaluation?
- Can the psychological evaluation be conducted by a qualified psychologist assistant or clinical social worker?
