In the context of Durable Medical Equipment (DME), a Scope of Work (SOW) or Standard Written Order (SWO) outlines the specific items, services, and associated conditions for the provision of DME. 

We follow the key elements that should be included in an order for DME (SWO/SOW)

* Beneficiary’s name or Health Insurance Provider Beneficiary Identifier (MBI): To identify the patient receiving the DME.

* Order Date: The date the order was written.

* Description of the item A detailed description of the DME item. This can be a general description (like “wheelchair” or “hospital bed”), a HCPCS code, or a specific brand name/model number.

* Quantity: If applicable, the quantity of the item to be dispensed.

* Treating practitioner name or National Provider Identifier (NPI): Identifying the prescribing doctor or practitioner.

* Treating practitioner’s signature: Signed by the prescribing practitioner. 

Important Considerations:

* Written Order Prior to Delivery (WOPD) For certain DME items, a signed and dated written order is required before delivery to the beneficiary.

* Detailed Medical Record The beneficiary’s medical record should support the medical necessity of the ordered DME.

* Separate Billing If options, accessories, or upgraded codes are included, they should be listed separately on the order.

* Compliance The SWO must be on file before the claim is submitted to Health Insurance Provider to ensure compliance with regulations. 

In essence, a DME order’s “scope of work” dictates exactly what DME is being provided, who is receiving it, who ordered it, and the date it was ordered. This ensures proper documentation and facilitates timely and accurate reimbursement

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type. Complete absence of all Bill Types indicates that coverage is not influenced by Bill Type and the article should be assumed to apply equally to all claims.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination. Complete absence of all Revenue Codes indicates that coverage is not influenced by Revenue Code and the article should be assumed to apply equally to all Revenue Codes.