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Durable Medical Equipment (DME)

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most DME requests

(this workflow EXCLUDES: compression stockings, incontinence supplies, splints, wound care, enteral feeds, ostomy supplies, shoes)

Send an Epic chat to: MSH LandauerMedstar:
1) Attach the chart of the patient
2) Include your attending in the chat
3) Be prepared to update your note with requested text

all other DME requests (compression stockings, incontinence supplies, splints, wound care, enteral feeds/Ensure, ostomy supplies, shoes)

Epic dot phrase is .IMADME, which includes the information below:

Enteral Nutritional Therapy including Ensure

For enteral nutritional therapy for nasogastric, jejunostomy, or gastrostomy tube feeding please complete .MSENSURE and route to p IMA Medication Prior-Auth Req. You will also need to provide a physical script and letter and route to SW.

For oral nutritional therapy like ensure insurance will likely not cover unless there is documented malabsorption or BMI < 18.5. A nutritionist can be helpful in gathering the appropriate documentation. Do not send a prior authorization request to p IMA Medication Prior-Auth Req for these cases.

CGM

Medicare

Use the MSH LandauerMedstar workflow above. A CGM will be mailed to the patient.

All other insurances

Send an E-prescription for the following to the patient's pharmacy:
1) Dexcom G7 1 sensor q10d
2) Dexcom G7 receiver x 1
3) Freestyle Libre 2 - 1 sensor q14d
4) Freestyle Libre 2 reader x 1

The pharmacy can figure out which of those is covered! Would suggest including a note to pharmacy about the particular indication for CGM, for example:
* requires BG check 4x/d
* frequent hypoglycemia or hypoglycemia unawareness or history of severe hypoglycemia requiring intervention
* multiple insulin injections per day