SCOOP Rx Template

As stated in Section 5.9 of the Medicare Program Integrity Manual, "If replacement supplies are needed for the therapeutic use of purchased DMEPOS (durable medical equipment), the treating physician must specify on the order, or on the CMN, the type of supplies needed and the frequency with which they must be replaced, used, or consumed." The physician can facilitate the timely replacement of transtracheal catheters and supplies by prescribing home oxygen with a precisely worded Detailed Written Order, or a revised certificate of medical necessity, for transtracheal catheters and related supplies.

The Medicare Home Oxygen Therapy Order (6/18 draft template v4.2) adapted for transtracheal oxygen is provided in the following link (» SCOOP Rx Template)Most browsers (e.g., Internet Explorer etc.) open the pdf document in their own viewers and permit data to be typed in fields and boxes to be checked with a mouse, but the completed form usually needs to be printed for physician signature by hand. If the clinician wants to electronically sign the pdf version, it can be downloaded from any browser then opened in Acrobat Reader DC . Enabling the Acrobat extension in Chrome allows the SCOOP prescription template to be filled, signed, printed and saved from within Chrome. Firefox file settings can also be configured to specify that pdf documents open in Acrobat Reader DC within the browser where the template can be filled, signed, printed and saved to disk. 

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