A Medicare beneficiary receiving enteral nutrition (EN), or formula fed through a feeding tube, in the hospital and planning to go home on EN therapy will require documentation to help ensure home enteral therapy is covered by traditional Medicare after hospital discharge. Below are helpful resources to identify what is needed when planning for home EN coverage for a Medicare beneficiary.
(Source: See 2021 EN Policy Article for list of ICD-10 codes)
A feeding pump must be justified. (Source: See new Enteral Local Coverage Determination 9/5/21)
Standard Written Order (SWO) – Must contain all the following:
(Source: Standard Documentation Requirements for All Claims Submitted to DME MACs)