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LCD - Commode

Coverage Summary:

A commode is covered when the patient is physically incapable of utilizing regular toilet facilities in one of the following situations:

    1. Patient is confined to a single room, OR;
    2. Patient is confined to one level of the home environment and there is no toilet on that level, OR;
    3. Patient is confined to the home and there are no toilet facilities in the home.

Order Requirements:

  • DME Order Form
  • Dr. must be PECOS registered for all Medicare orders.

  1. Patient's Name
  2. Detailed description of specific equipment being ordered (Commode, Drop Arm Commode, Heavy Duty Commode, etc.)
  3. Ordering Physician’s NPI
  4. Ordering physician’s legible signature (personally written or electronically signed by the physician, stamps are not accepted by insurance).
  5. Ordering physician’s legible signature date (personally written or electronically signed by the physician, stamps are not accepted by insurance).
  6. Start date of the order – if different than the Physician's signature date.

Coverage Detail:

A commode is covered when the beneficiary is physically incapable of utilizing regular toilet facilities.

This would occur in the following situations:

  1. The beneficiary is confined to a single room, or
  2. The beneficiary is confined to one level of the home environment and there is no toilet on that level, or
  3. The beneficiary is confined to the home and there are no toilet facilities in the home.

  • Extra Wide/Heavy Duty Commode is covered when patient weighs more than 300 lbs.

  • Commode Chair with Detachable Arms is covered when it facilitates transferring of the patient or if the patient has a body configuration that requires extra width.