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CMN/DIF Elimination Information

CMS is eliminating all remaining Certificates of Medical Necessity (CMNs) and Durable Medical Equipment Forms (DIFs) effective for claims with dates of service on or after January 1, 2023.

Effective for claims with dates of service on or after January 1, 2023, claims that are received with CMNs or DIFs attached will be rejected and returned to the supplier.

The following forms should not be submitted for claims with dates of service on or after January 1, 2023:

  • CMS-484 – Oxygen
  • CMS-846 – Pneumatic Compression Devices
  • CMS-847 – Osteogenesis Stimulators
  • CMS-848 – Transcutaneous Electrical Nerve Stimulators
  • CMS-849 – Seat Lift Mechanisms
  • CMS-854 – Section C Continuation Form
  • CMS-10125 – External Infusion Pumps
  • CMS-10126 – Enteral and Parenteral Nutrition

Affected LCDs

Requirement of a CMN or DIF (CMS forms 484, 846, 847, 848, 849, 10125, and 10126) is eliminated for claims with dates of service on or after January 1, 2023, in the applicable DME MAC Local Coverage Determinations (LCDs) and LCD-related Policy Articles:

CMNs:

  • Osteogenesis Stimulators LCD (L33796) and related Policy Article (A52513)
  • Oxygen and Oxygen Equipment LCD (L33797) and related Policy Article (A52514)
  • Pneumatic Compression Devices LCD (L33829) and related Policy Article (A52488)
  • Seat Lift Mechanisms LCD (L33801) and related Policy Article (A52518)
  • Transcutaneous Electrical Nerve Stimulators (TENS) LCD (L33802) and related Policy Article (A52520)

DIFs:

  • Enteral Nutrition LCD (L38955) and related Policy Article (A58833)
  • External Infusion Pumps LCD (L33794) and related Policy Article (A52507)
  • Parenteral Nutrition LCD (L38953) and related Policy Article (A58836)

Claim Instructions

For claims with dates of service on or after January 1, 2023, suppliers must not submit a CMN or DIF with the claim. If a CMN or DIF is included with the claim, the claim will be rejected and returned to the supplier.

For claims with dates of service on or before December 31, 2022, if the CMN or DIF is required, it must be submitted with the claim, or be on file with a previous claim.

Reminder: For dates of service affected by the COVID-19 Public Health Emergency (PHE) – i.e., claims with dates of service on or after March 1, 2020 and for the duration of the COVID-19 PHE – certain items or services do not require submission of a CMN or DIF for processing of the claim. CMS' interim final rule with comment (CMS-1744-IFC), which published on April 6, 2020, identified that clinical indications for coverage associated with certain LCDs and NCDs would not be enforced during the COVID-19 PHE. Based on claims processing issues that would result from missing information (for instance) on CMNs or DIFs, in relation to the non-enforcement of clinical indications, CMS also determined that CMNs and DIFs would not be required for oxygen claims and external infusion pump claims (respectively) during the COVID-19 PHE. Refer to the DME MAC joint publication titled CMS Issues Interim Final Rules with Comment (CMS-1744-IFC & CMS-5531-IFC) – COVID-19 Public Health Emergency for additional information concerning the COVID-19 PHE and effects on coding of claims for certain items or services.

Educational Resources:

Joint DME MAC Publications:

LCD and Policy Article Revision Summaries:

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