Certificate of Medical Necessity (CMN) and DME Information Form (DIF) Elimination

CMS is eliminating all remaining CMNs and DIFs effective for claims with dates of service on or after January 1, 2023. Providers and suppliers shall not submit a CMN or DIF with claims for dates of service on/after January 1, 2023. Due to electronic filing requirements, claims received with these forms attached will be rejected and returned to the provider or supplier.

CMS seeks to reduce burden and modernize processes to ensure a reduction in improper payments and an increase in customer satisfaction. The CMN and DIF were originally required to help document the medical necessity and other coverage criteria for selected DMEPOS items. In the past, a supplier received a signed CMN from the treating physician or created and signed a DIF to submit with the claim. Due to improvements in claims processing and medical records management, the information found on CMNs or DIFs is available either on the claim or in the medical record and is redundant. Therefore, to reduce burden and increase customer satisfaction, providers and suppliers shall not submit these forms for services rendered on or after January 1, 2023.

For claims with dates of service prior to January 1, 2023, processes will not change and if the CMN or DIF is required, it will still need to be submitted with the claim or be on file with a previous claim.

For claims with a date of service on or after January 1, 2023, a CMN cannot be used as the Standard Written Order (SWO) or Written Order Prior to Delivery (WOPD). CMNs that were signed and dated prior to January 1, 2023, are valid for 12 months and may continue to be utilized as the SWO/WOPD until the CMN expires.

The current forms that shall be eliminated are as follows:

CMN

  • 484 Oxygen
  • 846 Pneumatic Compression Devices
  • 847 Osteogenesis Stimulators
  • 848 Transcutaneous Electrical Nerve Stimulators
  • 849 Seat Lift Mechanisms
  • 854 Section C Continuation Form

DIF

  • 10125 External Infusion Pumps
  • 10126 Enteral and Parenteral Nutrition

Resources

 

Last Updated Tue, 17 Jan 2023 15:23:31 +0000