20-919 Avoid Delivery Delays When Ordering Blood Pressure Monitors for Medi-Cal Members

Date: 11/30/20

Follow these guidelines when placing orders.

Digital blood pressure cuffs for home use are a covered benefit for California Health & Wellness Plan (CHWP) members. CHWP has made special arrangements with Western Drug Medical Supply, a durable medical equipment (DME) supplier, to stock and provide these items, which are not easily available from other DME suppliers.

What you need to know before placing an order.

• Blood pressure cuffs are a Medi-Cal covered benefit for any ICD-10-CM diagnosis code that justifies medical necessity.
• Members are limited to one digital blood pressure cuff per member every five years. Units are provided with instructions and batteries.
• Members must select an automated digital device to support quality improvement reporting.
• A prescription is not required but would be helpful to ensure the correct item is selected.
• Prior authorization is not required. However, providers are required to submit a written DME order.
• The order should include the following:
  • Patient’s name
  • Date of birth
  • Member identification (ID) number
  • Member address
  • Member telephone number
  • Diagnosis
  • The provider’s full name and signature
  • HCPCS code: A4670-NU Automatic Blood Pressure Monitor
  • Date of service
• Missing information will delay the delivery of the DME.

How to place an order.

A written DME order or prescription must be signed by a licensed provider and faxed or emailed to:

Attention: Celeste Melgoza
Western Drug Medical Supply
Phone: 1-818-956-6691
Fax: 1-818-956-6695 or 1-818-551-9612
E-mail

A fax cover sheet must accompany all fax transmissions of Protected Health Information. The cover sheet must be labeled “PROTECTED HEALTH INFORMATION.”

Members will receive their equipment 24-48 hours after the DME supplier verifies the member’s eligibility and confirms the mailing address. Members who have questions or who have defective equipment can call Western Drug Medical Supply directly at 1-800-891-3661.

Additional Information

Providers are encouraged to access CHWP’s provider portal for real-time information, including eligibility verification, claims status, prior authorization status, plan summaries, and more.

If you have questions regarding the information contained in this update, contact CHWP at 1-877-658-0305.