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Ohio Administrative Code (Last Updated: January 12, 2021) |
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5160 Medicaid |
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Chapter5160-10. Medical Supplies, Durable Medical Equipment, Orthoses, and Prosthesis Providers |
5160-10-33. DMEPOS: commodes
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(A) Payment may be made for a commode if both of the following criteria are met:
(1) A medical condition, documented in the individual's medical record, prevents the individual from accessing the toilet facilities of the individual's place of residence; and
(2) The commode has been prescribed by a qualified practitioner.
(B) Additional coverage criteria are specific to particular commodes, and the satisfaction of these criteria must be ocumented in the individual's medical record:
(1) For an extra-wide or heavy-duty commode, either the individual weighs at least three hundred pounds or, if the individual weighs less than three hundred pounds, the medical necessity of the commode is established in detail.
(2) For a commode with detachable arms, the individual has a documented functional need (such as extra open space for transferring to and from the commode).
(C) Payment will not be made for the concurrent dispensing of both a commode and a bedpan.