Citizens Memorial Healthcare



BEFORE DISPENSING YOUR PT'S EQUPIMENT—HOSPITAL BED:We recently received a request from your patient for the following equipment: hospital bed. The documentation that we have on file from a recent office visit does not meet Medicare guidelines. Before dispensing a hospital bed, we will need new documentation supporting Medicare criteria. The patient will not be able to receive equipment unless proper documentation has been recorded in the pt's medical records. If you have any questions, please contact me at 417-326-3584.Thank you, DarleneCMH Home Medical EquipmentMedical Documentation Specialist HOSPITAL BED—Medical records will need to meet Medicare's criteria below. Thank you. NOTE: THE BOLD PRINT BELOW ARE THE KEY WORDS THAT WE NEED TO BILL MEDICARE 3(You need to paint a picture and tell a story of the pt's current condition.)HOSPITAL BED REQUIREMENTSA fixed height hospital bed (E0250, E0251, E0290, E0291, and E0328) is covered if one or more of the following criteria (1-4) are met and the criteria for #5 are met:The beneficiary has a medical condition which requires positioning of the body in ways not feasible with an ordinary bed. Elevation of the head/upper body less than 30 degrees does not usually require the use of a hospital bed, or The beneficiary requires positioning of the body in ways not feasible with an ordinary bed in order to alleviate pain, or The beneficiary requires the head of the bed to be elevated more than 30 degrees most of the time due to congestive heart failure, chronic pulmonary disease, or problems with aspiration., or The beneficiary requires traction equipment, which can only be attached to a hospital bed.-2381251079500AND the beneficiary requires frequent changes in body position, and/or has an immediate need for a change in body position.If documentation does not justify the medical need of the type of bed billed, payment will be denied as not reasonable and necessary.If the beneficiary does not meet any of the coverage criteria for any type of hospital bed it will be denied as not reasonable and necessary. ................
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