Bedside Commodes

Medicare Qualifications

A commode is covered when the beneficiary is physically incapable of utilizing regular toilet facilities, which would occur in the following situations:

• The beneficiary is confined to a single room, or
• The beneficiary is confined to one level of the residing home and there is no toilet on that level, or
• The beneficiary is confined to the home and there are no toilet facilities in the home.

 PLEASE NOTE:  

1. Bedside commodes are not covered if they are placed over the toilet in the bathroom
2. Extra wide / heavy duty commode chairs may be covered if the beneficiary weighs 300 pounds or more.
3. A commode chair with detachable arms may be covered if the detachable arms feature is necessary
   1. to facilitate transferring the beneficiary, or
   2. If the beneficiary has a body configuration that requires extra width.

A commode chair with a seat lift mechanism may be covered if the beneficiary has a medical necessity for a commode AND meets the criteria for a seat lift mechanism. The seat lift mechanism is intended for the beneficiary to walk after standing.

PLEASE NOTE: If the beneficiary can walk they rarely meet the criteria for a commode.

Required Documentation for Medicare

1. Prescription  – Must be signed and dated by treating physician or supplier signature if dispensing orders.
2. Detailed Written Order – Must be signed and dated by physician.
3. Chart Notes – Including information stating why a bedside commode is medically necessary (must comply with Qualifications listed above).

NOTE:

• Medical need must be documented in patient’s record
• DME supplier must have documentation on file detailing why patient is room-confined or unable to access toilet facilities.

If you are in need of more detailed information please click the link below to access the LCD.

Bedside Commode LCD