Certificates of Medical Necessity (CMNs) and DME Information Forms (DIFs) Elimination
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- Which forms are being eliminated?
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The following Office of Management & Budget (OMB) CMN and DIF forms will be eliminated for claims with dates of service on or after January 1, 2023:
- CMN CMS-484 – Oxygen
- CMN CMS-846 – Pneumatic Compression Devices
- CMN CMS-847 – Osteogenesis Stimulators
- CMN CMS-848 – Transcutaneous Electrical Nerve Stimulators
- CMN CMS-849 – Seat Lift Mechanisms
- CMN CMS-854 – Section C Continuation Form
- DIF CMS-10125 – External Infusion Pumps
- DIF CMS-10126 – Enteral & Parenteral Nutrition
Do not submit CMNs or DIFs for dates of service on or after January 1, 2023, as CMS will no longer process claims with a CMN or DIF attached. This includes revised and recertified CMNs and DIFs.
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- What will occur if the CMN/DIF is submitted with a claim for a date of service on or after January 1, 2023?
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Claims submitted with a with CMNs/DIFs will be returned to the provider or supplier, after which the claim may be resubmitted without the CMN/DIF attached.
The Common Electronic Data Interchange (CEDI) contractor will reject electronic claims submitted with CMNs/DIFs and return them to the provider or supplier. If this occurs, check your front end edit (FEE) reports.
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- With the elimination of CMNs/DIFs, will Medicare now require that the documentation be submitted with the claim?
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No. As usual, suppliers shall keep the documentation on file, and it must be available upon request.
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- What documentation will be required after the CMNs and DIFs are eliminated?
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This requirement has not changed. Prior to submitting a claim to Medicare, the supplier must have the following items on file:
- Standard Written Order (SWO)
- Written Order Prior to Delivery (WOPD) if applicable
- Information from the treating practitioner concerning the beneficiary's diagnosis
- Any information required for the use of specific modifiers or attestation statements as defined in certain DME MAC policies.
The supplier should also obtain documentation from the beneficiary's medical record to assure that coverage criteria for an item have been met.
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- Will same/similar history still be available for affected items in myCGS?
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Yes. Information on how to review Same/Similar equipment history is available in the myCGS User Manual.
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- Does the CMN/DIF elimination apply to the Statement of Certifying Physician for therapeutic shoes?
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No. A Statement of Certifying Physician for therapeutic shoes is still required, and we recommend using the form attached to the Therapeutic Shoes for Persons with Diabetes Local Coverage Determination (LCD L33369).
Additional information including updates to the applicable LCDs and policy articles will be published with additional details in the near future. Join the Electronic Mailing List to sign-up to receive updates.
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