DME MACs publish the documentation requirements, including the conditional order rule
Policy article · high importance
- Announced
- 2025-07-17
A Joint DME MAC Publication, issued by all four jurisdictions on the same day, answering the two questions suppliers had actually asked about standard written orders. An order that specifically listed A4351, A4352 or A4353 needed replacing. An order written as a general description did not.
The answer to the second question is the one that gets dropped in summary: "Since the beneficiary's current SWO verbiage is descriptive of the new hydrophilic catheter HCPCS code(s), no new order is required."
Codes this entry bears on
Sources
- [1] Documentation Requirements for New Urological Supplies Codes · Joint DME MAC Publication (Noridian Healthcare Solutions and CGS Administrators) · checked 2026-08-07
A JOINT DME MAC PUBLICATION, NOT A NORIDIAN ARTICLE, and it says so in its own subheading. The identical text is published by all four jurisdictions and every copy was fetched on 2026-08-07: Noridian JA (this URL, HTTP 200, 143,027 bytes), Noridian JD at .../web/jddme/policies/dmd-articles/2025/documentation-requirements-for-new-urological-supplies-codes, and CGS JB and JC at cgsmedicare.com/{jb,jc}/pubs/news/2025/07/cope181960.html (HTTP 200, 40,620 bytes for JC). One jurisdiction's URL is used as the anchor. This is the source of the conditional order rule, and reading only one branch of its two-question Q&A is how the blanket "every order must be rewritten" version got into circulation.