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CMS announces the elimination of CMNS and DIFs

In the weekly CMS MLN Newsletter published Thursday, May 5, 2022, CMS announced,  “Suppliers, billers, and vendors: Certificates of medical necessity (CMNs) and the durable medical equipment (DME) information forms (DIFs) are discontinued...

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CMS Updates to Lists Related to Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Conditions of Payment [CMS-6081-N]

By Donna Youngblood, RN, Clinical Consultant at The van Halem Group CMS released its long awaited Master List on January 12, 2022 with new codes being added to both the Master list and Required List. In addition, they have added Power Operated Vehicles...

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CMS new demonstration project to include Nurse Practitioners as Certifying Physicians for Therapeutic Shoes and Inserts

Effective January 1, 2021 and extending through December 31, 2025, CMS is exercising its authority to allow nurse practitioners to certify that an order for diabetic shoes is required under a new model demonstration for certain states. Under this...

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CMS ABN form updated

CMS has updated the Advance Beneficiary Notice of Noncoverage (ABN) (Form CMS-R-131). Providers can use the new form now, and mandatory use of the form will be on 8/31/2020. The form is valid through 06/30/2023. On or after 8/31/2020, issuing an ABN...

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Continued Need for Supplies

By Carrie Nienberg, RN, Director of Clinical Operations Did you know ongoing continued need isn’t required for urological or ostomy supplies? In the ostomy policy article, under continued need it indicates once initial medical need is established,...

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MACs issue KX Modifier guidance during the PHE

On May 14, 2020 a Joint DME MAC Bulletin Article was published to provide guidance on use of the KX modifier. Use of the KX modifier indicates that specific required documentation is on file in the patient's medical record. CMS' final rule, which was...

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Quick Tip: Proof of Delivery Signature Guidelines during the COVID-19 pandemic

On Friday the DME MACs provided the following update regarding signature guidelines and proof of delivery: CMS is currently reviewing signature guidelines that have been affected by the COVID-19 pandemic.  At this time suppliers should do their...

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New guidance on timing of the 6-month face-to-face encounter and Standard Written Order for PMDs

By Carrie Nienberg, RN, Director of Clinical Operations Currently, Policy Article A52498, revised on 01/01/20, indicates a face-to-face encounter must occur within six months prior to the order date on the Standard Written Order (SWO). If the beneficiary...

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Hospital Beds and Manual Wheelchairs added to RAC Approved Issues

CMS has approved two new topics for the DMEPOS RAC, Performant, to begin reviewing, effective March 1, 2020. Hospital Beds: Medical Necessity and Documentation Requirements Description: Hospital Beds must meet basic coverage criteria whether at...

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CMNs and ABNs are nearing expiration...what do you do?

By Carrie Nienberg, RN Clinical Director CMNs for Oxygen, Pneumatic Compression Devices, Osteogenesis Stimulators, Transcutaneous Electrical Nerve Stimulator (TENS), Seat Lift Mechanisms, External Infusion Pumps, Enteral and Parenteral nutrition,...

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