Providers debate CMNs, templates

YARMOUTH, Maine - While respiratory providers say they might support doing away with CMNs for oxygen, some aren't sure about the potential for an electronic clinical template to replace them.

“I think asking the physician to fill out anything is not helpful,” said Robin Powers, billing supervisor for Friendship Home Medical Equipment in Wise, Va. “Anything they just have to sign they are OK with.”

During a recent Open Door Forum, CMS sought input on whether providers would like to see CMNs and DIFs eliminated. Currently, CMS requires CMNs for several products, including oxygen.

At the same time, CMS is developing templates for oxygen, along with power mobility devices and lower limb prostheses, as part of a pilot project.

A template is certainly an option, says provider George Kucka, but it would need to be thought through very carefully.

“What's the nature of the documentation going to be, and according to whose criteria is it that the documentation is filled out correctly,” said Kucka, chairman of AAHomecare's HME/Respiratory Therapy Council and president of Fairmeadows Home Health Center in Schererville, Ind. “I've got no problem with a template—the less paper the better—but it's got to be a format that's acceptable to CMS and not challenged on audit.”

For an industry beset by paperwork and audits, some providers are understandably wary of eliminating the familiar—if redundant—CMN.

“They keep everybody on the same page,” said Cory Baker, compliance officer for Choice Medical Supply in Abilene, Texas. “At least physicians are familiar with it. Making changes, along with everything else that's changing, might lead to more confusion and more opportunity for mistakes.”

But other providers say CMNs have got to go.

“They're making it way too hard to get anybody equipment,” said Steve Gulick, president/owner of Illiana Medical Equipment in Danville, Ill. “We've got the face-to-face requirement, detailed written orders, chart notes and then you throw a CMN in the middle of it? Get rid of those things.”