Documentation Requirements Valid written order that contains Prescription Beneficiary146s name Items to be dispensed ie single point cane quad cane Patients146 Height and Weight L ID: 817583
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Canes and Crutches Documentation Requir
Canes and Crutches Documentation Requirements Valid written order that contains: (Prescription) Beneficiary’s name Item(s) to be dispensed i.e. (single point cane, quad cane, Patients’ Height and Weight Length of need i.e. (lifetime, 6 months) Treating physician’s signature Date the treating physician signed the order Qualifying Documented Criteria (Well documented in the patient chart notes) Medical records* documenting that of the following criteria are met: The patient has a mobility limitation that significantly impairs his/her ability to participate in one or more mobilityrelated activities of daily living (MRADL) in the home; AND The patient is able to safely use the cane or crutch; AND The functional mobility deficit can be sufficiently resolved by use of a cane or crutch.