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Nebulizer Treatment Clinical Documentation According to the CMS, nebulizer claims must include a Written Order Prior to Delivery (WOPD), which must be a 5 Element Order (5EO) that includes all of the following elements: Beneficiarys name Item of DME ordered Signature of the prescribing practitioner Prescribing practitioners National Provider Identifier (NPI) The date of the order A completed 5EO within 6 months after the required Affordable Care Act (ACA) face-to-face examination The suppliers receipt of the 5EO before delivery of the listed item(s) It is also recommended that a date stamp or equivalent must be used to document the 5EO receipt date

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