Ohio Administrative Code Search

...(c) The provision of or payment for the purchase of a medically necessary bathing seat for a resident of a long-term care facility (LTCF) is the responsibility of the LTCF. Therefore, claims submitted to the department for bathing seats furnished to LTCF residents will be denied. (d) Bathing seats on wheels are not to be used simply as transport chairs from which an individual then transfers to a bat...

... oscillation (HFCWO) device on a rental/purchase basis. (2) The default certificate of medical necessity (CMN) is form ODM 10229, "Certificate of Medical Necessity: High-Frequency Chest Wall Oscillation Devices" (7/2018). (3) An initial trial period of at least two months is required. Payment may be made for rental during this trial period, excluding any portion that coincides with an inpati...

... oscillation (HFCWO) device on a rental/purchase basis. (2) Purchase of a HFCWO device will not be considered without an initial trial period lasting at least two months, excluding any portion that coincides with an inpatient hospital stay. Payment may be made for rental during this trial period. (3) The default certificate of medical necessity (CMN) is form ODM 10229, "Certificate of Medical Ne...

...de for an apnea monitor on a rental/purchase basis. (2) The monitoring unit must meet current United States food and drug administration guidelines. (3) The default certificate of medical necessity (CMN) form is the ODM 02900, "Certificate of Medical Necessity: Apnea Monitors" (rev. 7/2018). (4) Payment for the initial rental of an apnea monitor is limited to four months. For this initial renta...

...ade either for additional rental or for purchase, only if the following conditions are satisfied: (a) The monitoring unit meets current United States food and drug administration guidelines. (b) The provider is capable of performing all of the following services: (i) Arranging to have certified individuals provide infant cardiopulmonary resuscitation (CPR) training to caregivers; (ii) Prov...

...be made for a TENS unit on a rental/purchase basis. (2) The default certificate of medical necessity (CMN) form is the ODM 03402, "Certificate of Medical Necessity: Transcutaneous Electrical Nerve Stimulation (TENS) Units" (rev. 7/2018). The CMN must include one of the following statements of need: (a) For neurogenic pain, the following information: (i) An attestation that the individual ...

...be made for a TENS unit on a rental/purchase basis. (2) The default certificate of medical necessity (CMN) form is the ODM 03402, "Certificate of Medical Necessity: Transcutaneous Electrical Nerve Stimulation (TENS) Units" (rev. 7/2018). The CMN includes one of the following statements of need: (a) For neurogenic pain, the following information: (i) An attestation that the individual is exper...

...me with a wheelchair at the time of purchase: (a) A sling or solid seat with back, a captain's chair, or a stadium-style seat; (b) Standard casters or wheels with tires; (c) Standard armrests; (d) Standard front rigging, such as non-elevating legrests with footrests or a footplate; (e) Wheel locks or brakes; (f) With a power mobility device, motors; (g) With a power mobility device, a non-expandab...

... limb. (B) Payment may be made for the purchase of a pneumatic appliance. Payment may be made on a rental/purchase basis for a pneumatic compressor. (C) The default form is the ODM 02929, "Certificate of Medical Necessity: Pneumatic Compression Devices and Accessories" (rev. 7/2018). The CMN must include the following information: (1) A statement that previous treatment produced no signific...

... months), for rental with subsequent purchase, or for purchase outright, as the prescribing practitioner determines to be appropriate. For a covered pneumatic appliance or accessory, payment is made for purchase.

...made for a hospital bed on a rental/purchase basis. (2) The default certificate of medical necessity (CMN) form is the ODM 02910, "Certificate of Medical Necessity: Hospital Beds and Bed Accessories" (rev. 7/2018). The CMN must include an attestation that at least one of the following criteria is met: (a) The individual's condition (e.g., congestive heart failure, chronic obstructive pulmonary d...

...made for a hospital bed on a rental/purchase basis. (2) The default certificate of medical necessity (CMN) form is the ODM 02910, "Certificate of Medical Necessity: Hospital Beds and Bed Accessories" (rev. 7/2018). The CMN includes an attestation that at least one of the following criteria is met: (a) The individual's condition (e.g., congestive heart failure, chronic obstructive pulmonary disea...

...de for a pulse oximeter on a rental/purchase basis. The default certificate of medical necessity (CMN) form is the ODM 03401, "Certificate of Medical Necessity: Pulse Oximeters" (rev. 7/2018). The CMN must include an attestation by a prescriber that a need exists either for diagnostic monitoring or for continuous monitoring: (a) For diagnostic monitoring undertaken in response to an acute cli...

...de for a pulse oximeter on a rental/purchase basis. The default certificate of medical necessity (CMN) form is the ODM 03401, "Certificate of Medical Necessity: Pulse Oximeters" (rev. 7/2018). The CMN includes an attestation by a prescriber that a need exists either for diagnostic monitoring or for continuous monitoring: (a) For diagnostic monitoring undertaken in response to an acute clinica...

...o the main purpose of the SGD; (c) Purchase, rental, lease, subscription, or maintenance associated with a cellular phone, even if the cellular phone has the capability to perform SGD functions; or (d) Features that may be added on to some models of SGD but have been integrated into the particular SGD under consideration. (C) Claim payment. (1) The payment amount for a portable/tablet computer...

...e. (1) Payment may be made for the purchase of a single-user manual or electric lactation pump as a medical supply item or for the rental of a multiple-user lactation pump for a period of ninety days. (2) The default certificate of medical necessity (CMN) form is the ODM 01901, "Certificate of Medical Necessity: Lactation Pumps" (rev. 7/2018). The CMN must include an attestation to at least ...

...or both of the following purposes: (a) Purchase of a single-user manual or electric lactation pump as a medical supply item and purchase of any necessary replacement supplies; or (b) Rental of a multiple-user lactation pump. (2) For a single-user manual or electric lactation pump, a prescription is sufficient. No separate certificate of medical necessity (CMN) is needed. (3) For a multiple-use...

...2) Separate payment may be made for the purchase of one complete set of accessories (e.g., pads, straps, hook-and-loop closures) if the individual does not already have such accessories as a result of previous use of a CPM device. (B) Requirements, constraints, and limitations. No payment is made for a CPM device in any of the following circumstances: (1) The device is used on a joint other ...

...eparate payment may be made for the purchase of one complete set of accessories (e.g., pads, straps, hook-and-loop closures) if the individual does not already have such accessories as a result of previous use of a CPM device. (B) Constraints and limitations. No payment is made for a CPM device in any of the following circumstances: (1) The device is used on a joint other than the knee; (2)...

...e. (1) Payment may be made for the purchase only of a noninvasive osteogenesis stimulator. (2) The default certificate of medical necessity (CMN) form is the ODM 07134, "Certificate of Medical Necessity: Osteogenesis Stimulators" (rev. 7/2018). The CMN must include an attestation that appropriate coverage criteria are met. (3) Payment may be made for a spinal electrical osteogenesis stimula...

...e. (1) Payment may be made for the purchase only of a noninvasive osteogenesis stimulator. (2) The default certificate of medical necessity (CMN) form is the ODM 07134, "Certificate of Medical Necessity: Osteogenesis Stimulators" (rev. 7/2024). The CMN includes an attestation that appropriate coverage criteria are met. (3) Payment may be made for a spinal electrical osteogenesis stimulator ...

...ernal insulin infusion pump on a rental/purchase basis. The initial rental period is limited to three months. (2) The default certificate of medical necessity (CMN) form is the ODM 07136, "Certificate of Medical Necessity: Insulin Pumps" (rev. 7/2021). The CMN includes an attestation that appropriate documentation is kept in the individual's medical record to demonstrate that the following criter...

...evice. (B) Payment may be made for the purchase of a cranial remolding device to treat any of the following conditions if the associated criteria are met. (1) Positional (non-synostotic) plagiocephaly: (a) The individual is at least three months old but not older than eighteen months; (b) Any of the following asymmetries is present: (i) A right/left discrepancy in the skull base of at least ...

...evice. (C) Payment may be made for the purchase of a cranial remolding device to treat any of the following conditions if the associated criteria are met. (1) Positional (non-synostotic) plagiocephaly: (a) The individual is at least three months old but not older than eighteen months; (b) Any of the following asymmetries is present: (i) A right/left discrepancy in the skull base of at least...

...e. (2) Payment may be made for the purchase of a CGM and for the periodic purchase of replaceable CGM components. (3) The default certificate of medical necessity (CMN) form is the ODM 10277, "Certificate of Medical Necessity: Continuous Glucose Monitors" (10/2022). The CMN includes the following information, for which appropriate documentation is kept in the individual's medical record. (a...