Tag: Certificate of Medical Necessity (CMN)
‘Headache’ will go away for more than just oxygenÂ
June 17, 2022Liz Beaulieu, Editor
WATERLOO, Iowa – Much of the celebration around the elimination of the certificate of medical necessity (CMN) requirement on Jan. 1, 2023, has focused on oxygen concentrators, but four other product categories will also benefit from the change.
Seat lift mechanisms, TENS devices, pneumatic compression devices and osteogenesis stimulators will all no longer require CMNs starting next year.
“It’s a big deal,” said Ronda Buhrmester, senior director of payer...
‘Providers have chased their last CMN for oxygen’
June 10, 2022Liz Beaulieu, Editor
BALTIMORE – With a new clarification from CMS and the DME MACs, it’s “crystal clear” that certificates of medical necessity are no longer required for oxygen claims during the public health emergency, say industry experts.
“The guidance is crystal clear and precise,” said Andrea Stark, a Medicare consultant and reimbursement specialist for MiraVista. “Providers have chased their last CMN for oxygen.”
CMS in June posted a joint...
CMS clarifies oxygen requirements
June 6, 2022HME News Staff
WASHINGTON – CMS has posted a joint DME MAC publication clarifying that certificates of medical necessity are not required for oxygen claims during the public health emergency.
The publication also clarifies that DME Information Forms are not required for external infusion pumps during the PHE.
“CMS-1744-IFC (an interim final rule issued April 6, 2020) stated that CMS would exercise enforcement discretion for clinical indications of coverage for the oxygen NCDs...
Stakeholders have concerns with CMS’s plans for CMN
May 5, 2022Liz Beaulieu, Editor
WASHINGTON – CMS’s plan to discontinue CMNs on Jan. 1, 2023, may cause problems for HME providers trying to comply with a new national coverage determination for home oxygen therapy that went into effect Sept. 27, say industry stakeholders.
Following the release of the NCD, CMS issued change requests to push new language to the decision manual and to trigger claims processing edits to align with the new guidelines, but nothing related to eliminating the CMN for oxygen specifically....
CMS to drop CMNs, DIFs
May 5, 2022HME News Staff
WASHINGTON – CMS will eliminate requirements for certificates of medical necessity (CMNs) and DME information forms (DIFs), starting with claims with service dates of Jan. 1, 2023, according to an MLNConnects article published yesterday.
Per the announcement, suppliers will not be able to submit CMN and DIF forms or their electronic claim data elements with claims for dates of service on or after that date. Suppliers must continue to submit CMN and DIF information for claims with...
New year could have shaky start
November 19, 2021Liz Beaulieu, Editor
YARMOUTH, Maine – The opportunities for HME providers in 2022 in a lot of ways hinge on the progress they make on the challenges in 2021, respondents to a recent HME Newspoll say.
That’s because one of the biggest challenges in 2021 – supply chain constraints, and the corresponding increase in pricing and surcharges – is expected to continue into 2022.
“The only thing that we are hoping for in 2022 is the easing of the supply chain issues and the return...
Regulatory: Watch out for MAC instructions
November 10, 2021Andrea Stark
Q. When can oxygen suppliers stop using the CMN?
A. Suppliers can stop using CMNs for oxygen setups with dates of service on and after Sept. 27, 2021. A recent change to the Home Use of Oxygen National Coverage Determination (NCD) eliminates the CMN requirement. In lieu of a CMN, suppliers need a standard written order from a treating practitioner.
To release initial claims for hypoxic patients, suppliers must confirm the medical records support the need for oxygen with test results...
Good riddance: Respondents support elimination of CMN
October 22, 2021Theresa Flaherty, Managing Editor
YARMOUTH, Maine – Outdated, redundant and confusing is the common refrain from HME Newspoll respondents who overwhelmingly support CMS’s decision to eliminate the CMN requirement for home oxygen therapy.
“The CMN is an outdated tool that simply seems to supply Medicare with another means to deny claims on technicalities,” wrote Josh Turner, billing manager at McAbee Medical in Decatur, Ala. “Everything on the CMN is in the medical record, so there is no reason...
Industry on home oxygen: We need ‘objective standards for review’
October 5, 2021HME News Staff
WASHINGTON – AAHomecare, VGM & Associates, the Council for Quality Respiratory Care and 11 other organizations are asking CMS to eliminate the medical record review for home oxygen therapy and to accept the clinician prescription/standard written order as the required documentation for establishing medical necessity.
These changes would protect against fraud and abuse, reduce the burden on clinicians and suppliers, and protect access for Medicare beneficiaries, the groups say in an...
CMS sunsets CMN for home oxygen
October 1, 2021Theresa Flaherty, Managing Editor
WASHINGTON – CMS on Sept. 27 posted a final national coverage determination for home oxygen, but now industry stakeholders must “wait and see” what the DME Medicare Administrative Contractors do with the changes.
While the effective date of the NCD is technically Sept. 27, it won’t be implemented until a later date, when the DME MACs update their local coverage determinations.
“There are a lot of positives here, and we will wait and see,” says...