COLUMBIA, S.C. – WOPD stands for written order prior to delivery. Medicare has a whole list of products for which it demands suppliers first obtain the written order before delivery… verbal orders cannot support delivery even if they are later confirmed in writing. The agency takes the order of operations for these products very seriously…it’s right there in the name.
Medicare is so serious that there are no do-overs. Submitting a claim with a noncompliant WOPD creates an uncurable error at the PTAN level.
Prior Authorization is a Natural Control
Most of the HCPCS codes on the Face-To-Face/Written Order Prior to Delivery (FTF/WOPD) List are also included on the list of products that require prior authorization. For items on both lists, prior authorization creates a natural control because suppliers have to produce a compliant WOPD to support the authorization request … you know …prior to delivery.
38 Codes Have No Prior Authorization Checkpoint
The vulnerability is greater for the 38 FTF/WOPD codes that do not require prior authorization because no outside process forces that pre-delivery check. These products stretch across numerous categories, including: hospital beds; oxygen; ventilators; manual wheelchairs; power wheelchairs with seat elevation; orthoses; and bone stimulators. In these cases, suppliers must rely entirely on their own internal controls.
Check Before Delivery and Again Before Billing
Suppliers should establish two checkpoints for the 38 HCPCS codes that require a WOPD but not prior authorization. Before delivery, the intake or delivery workflow should verify a compliant WOPD is in hand before the product reaches the beneficiary.
Catching the problem here is the cleanest solution because the supplier can stop the delivery and secure or correct the documentation before service occurs. Before claim confirmation and release, and as a secondary precaution, the billing team should verify the WOPD was obtained before delivery.
Hold claims when product delivery occurred before receipt of a compliant WOPD. The supplier can then obtain a compliant WOPD, redeliver the product using a new date of service, and submit the compliant claim.
The second checkpoint is not a substitute for a strong pre-delivery process. It acknowledges that mistakes happen and gives billing one last opportunity to prevent a correctable WOPD error from becoming an uncurable one. For these 38 codes, a simple second check before billing can be the difference between correcting a WOPD error and making it permanent.
Andrea Stark co-founded MiraVista LLC in 2003. She specializes in helping DME suppliers build reimbursement mastery within their organizations through online courses, custom training, direct staff support, and data-driven operational consulting.