Under Medicare guidelines, which documentation is required for HPN coverage when a malnourished patient has a partial small bowel obstruction and limited oral intake?

• A. The physician must write an order for nil per os
• B. A radiology report documenting obstruction
• C. Medical record must document failure of an enteral feeding trial, or explain why an feeding tube is not an option
• D. No further documentation is necessary

Answer: (C)