Bath Saftey

Note:  The following coverage criteria is for Medicare, other insurances may have different criteria and may be less stringent.  In most cases, meeting Medicare criteria will meet all other criteria’s.

Medicare does not cover any items for the bathroom except for a commode chair, and then only when the following Criteria has been met.

• A written signed and dated prescription is required before a commode chair is covered by Medicare.
• The face to face notes must describe the conditions for coverage as described below.

CRITERIA FOR A COMMODE CHAIR
 
A commode chair is covered when the patient is physically incapable of utilizing regular toilet facilities. This would occur in the following situations:

1. The patient is confined to a single room, or
2. The patient is confined to one level of the home environment and there is no toilet on that level, or
3. The patient is confined to the home and there are no toilet facilities in the home.

An extra wide/heavy duty commode chair is covered for a patient who weighs 300 pounds or more. If the patient weighs less than 300 pounds but the basic coverage Criteria for a commode chair are met, payment will be based on the least costly medically appropriate alternative.
A mobile commode chair is not medically necessary.
A commode chair with detachable arms is covered if the detachable arms feature is necessary to facilitate transferring the patient or if the patient has a body configuration that requires extra width. If these additional Criteria are not met but the coverage Criteria for a commode chair are met, payment will be based on the least costly medically appropriate alternative.