
Documentation Checklists
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- Ankle-Foot/Knee-Ankle-Foot Orthosis
– July 2024
- Commodes
– January 2023
- Continuous Glucose Monitors and Supplies
– January 2024
- Enteral Nutrition
– January 2024
- Glucose Monitors and Supplies
– January 2024
- Hospital Beds and Accessories
– April 2020
- Immunosuppressive Drugs
– January 2024
- Knee Orthoses
– July 2023
- Lower Limb Prostheses
– September 2024
- Manual Wheelchairs
– December 2024
- Nebulizers & Inhalation Drugs: Iloprost and Treprostinil
– January 2024
- Nebulizers & Inhalation Drugs: Large Volume Nebulizers
– February 2024
- Nebulizers & Inhalation Drugs: Small Volume Nebulizers
– January 2024
- Negative Pressure Wound Therapy Pumps
– January 2024
- Orthopedic Footwear
– February 2022
- Osteogenesis Stimulators
– September 2024
- Ostomy Supplies
– March 2024
- Oxygen and Oxygen Equipment – Beneficiaries Meeting Group I & II Criteria
– November 2024
- Parenteral Nutrition
– February 2025
- Positive Airway Pressure (PAP) Accessories and Supplies
– February 2024
- Positive Airway Pressure (PAP) Devices for the Treatment of OSA
– February 2024
- Power Mobility: Group 1 PWCs (K0813 – K0816) & Group 2 PWCs (K0820 – K0829)
– May 2020
- Power Mobility: Group 2 Single Power Option PWCs (K0835 – K0840) & Group 2 Multiple Power Option PWCs (K0841 – K0843)
– May 2020
- Power Mobility: Group 3 No Power Option PWCs (K0848 – K0855), Group 3 Single Power Option PWCs (K0856 – K0860), & Group 3 Multiple Power Option PWCs (K0861 – K0864)
– May 2020
- Power Mobility: Group 5 (Pediatric) PWCs with Single (K0890) or Multiple (K0891) Power Options & Push-Rim Activated Power Assist Device (E0986) for a Manual Wheelchair
– May 2020
- Power Mobility: POVs (HCPCS Codes K0800 – K0802 and K0806 – K0808)
– August 2023
- Replacement Orthosis During Reasonable Useful Lifetime
– August 2020
- Respiratory Assist Device – E0470 Bi-Level Pressure Capacity without Backup Rate
– February 2024
- Respiratory Assist Device – E0471 Bi-Level Pressure Capacity with Backup Rate
– February 2024
- Spinal Orthoses
– July 2024
- Support Surfaces: Group 1 Pressure Reducing Support Surface
– April 2021
- Support Surfaces: Group 2 Pressure Reducing Support Surface
– April 2021
- Support Surfaces: Group 3 Pressure Reducing Support Surface
– April 2021
- Surgical Dressings
– February 2024
- Therapeutic Shoes for Persons with Diabetes
– January 2021
- Urological Supplies: Intermittent Catheters
– February 2024