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Nebulizer Order Checklist

When ordering a nebulizer and respiratory medications, please provide the required documentation listed below:

  • Patient Demographic Information
  • Standard Written Order
  • Chart Note documentation of a face-to-face evaluation with the patient stating the reason for prescribing nebulizer therapy and medication.
Patient information form

Standard Written Order (SWO)

A SWO must contain all the following elements:

  • Beneficiary Name or Medicare Beneficiary Identifier (MBI)
  • Order Date
  • General description of the item
    • The description can be a general description, an HCPCS code, an HCPCS code narrative, or a brand name/model number
    • For equipment: In addition to the description of the base item, the SWO may include all concurrently ordered options, accessories, or additional features that are separately billed or require an upgrade code (list each separately)
    • For supplies: In additional to the description of the base items, the DMEPOS order/prescription may include all concurrently ordered supplies that are separately billed (list each separately)
  • Quantity to be dispensed, if applicable
  • Treating practitioner name or National Provider Identifier (NPI)
  • Treating practitioner’s signature
  • SWO date must be on or prior to the delivery date and needs to be filed prior to billing
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Documentation Requirements

Please include chart notes with the following information:

  • Documentation of medical need within three (3) months of the order date
  • Pulmonary Diagnosis
  • Medication and delivery modality
    • Nebulizer is needed to deliver a covered respiratory medication
  • Medication List
  • The practitioner’s signature on the medical records meets CMS signature requirements

Ordering from Lincare has never been easier.

Trust us to take care of your patients and enjoy the streamlined convenience you deserve. Lincare wants to make it as easy and efficient as possible to order your prescriptions.  Send orders via Electronic Ordering Platforms that include build-in documentation packages without the need of paper.

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DME Scripts
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GoScripts
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Parachute Health
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SureScripts
Or Send Via Fax to Your Local Lincare Center

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