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DMEPOS Templates


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Templates and Suggested Clinical Data Elements (CDEs) for Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS)

You can use the printable clinical templates or suggested CDEs to assist with documenting the following for certain DMEPOS items:

  • Face-to-Face (F2F) Encounters
  • Detailed Written Orders (DWOs) or Written Orders Prior to Delivery (WOPDs)
  • Laboratory Test Results

See a complete list of all clinical templates available for download, here.