On January 1, 2021, the new Medicare regulations went into effect. A Standard Written Order (SWO) must now be sent to a supplier before any durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) products can be charged. Before this new update’s implementation, which calls for a SWO, a Detailed Written Order (DWO) was necessary. The CMS-1713 Final Rule caused the DWO to become the SWO designation for these new standards.
Overview of Standard Written Order (SWO)
The SWO is a crucial document that Medicare and other insurance companies require and functions as a prescription for DME. It details the precise tools, volume, and duration of use for each item provided. The SWO is evidence that the treating healthcare professional gave the DME supplier a legitimate order. It minimises the possibility of reimbursement delays or denials by ensuring sufficient documentation and assisting in claim processing.
Importance of Correct SWO Documentation
To prevent claim rejections and adhere to payer regulations, it is essential for DME suppliers to have accurate and comprehensive SWO paperwork. The SWO should contain the patient’s name, the equipment’s description, the order date, the prescribing physician’s information, and the supplier’s contact details. The prescription writer must make sure the SWO is signed, dated, and legible. The SWO must also be completely documented and signed if there are any modifications or additions.
Complying with Payer-Specific SWO Guidelines in DME Billing
The SWO can be finished by someone besides the practitioner, unless otherwise stated. The SWO must still be evaluated and signed by the treating professional.
An SWO must have the following components:
- Medicare Beneficiary Identifier (MBI) or beneficiary’s name
- Dispatch date
- The broad description of the thing, which includes:
- A brief description, an HCPCS code, an HCPCS code narrative, or a brand name or model number are all acceptable forms of the description.
- Equipment – Any additional ordered items, attachments, or features may be paid separately or call for an upgraded code (mention each one separately).
- Any ordered supplies that are separately billed may be included in the DMEPOS order/prescription (note each separately).
- Dispensed amount
- Name or National Provider Identifier (NPI) of the treating physician
- Signature of the healthcare provider
The SWO can be made by the supplier and given to the doctor for signature. A signed SWO is required from the physician before billing a claim to Medicare. The SWO is not a part of the medical record, so all ancillary medical documentation must still be gathered.
Signature Requirements for SWO:
- The only accepted form of signature is a valid handwritten or digital one.
- Signatures with stamps are not accepted.
- Dates with stamps are not acceptable.
- Any illegible signature must have a signature log, which must contain the signer’s PRINTED name, initials, signature, and credentials.
- The SWO or medical record is invalid if neither party has signed it.
Face-to-Face (F2F) Requirements for SWO in DME Billing:
- It must be noted in the medical file.
- Include progress reports, H&P, or hospital discharges.
- supporting documents
- clinical notes
- Notes on PT/OT
- Lab, x-ray, and blood work are noted by RT.
Frequency is Still Required for an SWO
Frequency is still required for supply items on a SWO. Medicare will evaluate the medical records to check that the frequency being billed is substantiated, even though the new SWO guidelines removed frequency from the list of requirements.
- Where should the frequency be included?
The SWO or medical records must make the frequency explicit. Unfortunately, neither practitioners nor doctors routinely note frequency in patient records.
- Why is frequency required while it is not on the SWO criteria list?
Suppliers are paid depending on frequency by Medicare and other payers. If the monthly supply quantity is actually medically necessary, Medicare and Third-Party Payors want to know. They must see it on the SWO or in their medical records because the number of things does not always correspond to the frequency.
- Frequency and SWO
Overall, before invoicing DMEPOS products, the new Medicare requirements now demand a SWO (instead of a DWO). The frequency must be indicated even though it is not required by the SWO criteria. The SWO or the patient’s medical file may contain information about the frequency.
Keep Up to Date on all DME Billing Changes
To improve revenue cycle management and ensure payer compliance, DME providers must implement the Standard Written Order (SWO) process. Accurate SWO documentation speeds up reimbursement and reduces claim denials. DME billing outsourcing to a reputable medical billing business, like 24/7 Medical Billing Services, guarantees effective billing operations and maximum revenue generation. By utilising the power of SWO and working with the team to meet your DME billing needs, you can stay ahead of the curve in the ever evolving healthcare sector.
