DME MACs drop CMNs for oxygen, infusion services

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Tuesday, May 12, 2020

WASHINGTON – The DME MACs on May 7 announced that they will not require CMNs for oxygen claims during the COVID-19 public health emergency.

The update follows CMS’s decision not to enforce clinical indications of coverage for the oxygen NCDs and LCDs, as outlined in an April 6 interim final rule.

“After carefully reviewing the CMN and the related claims processing issues that would result from having missing information or having clinical information for which the form was intended, CMS has determined that requirements for a CMN for oxygen claims will not be enforced during the COVID-19 PHE,” CGS stated in a bulletin.

The same concerns apply to external infusion pumps and, therefore, the DME MACs will not require DIFs for these claims.

To file claims without CMNs, the DME MACs recommended:

“Suppliers should continue to use the appropriate modifiers, including the KX modifier where applicable, for all HCPCS codes included in the NCDs and LCDs. In addition, the CR modifier (CATASTROPHE/DISASTER RELATED) should be added to the HCPCS code(s) billed. Finally, suppliers are instructed to enter "COVID-19" in the NTE 2400 (line note) or NTE 2300 (claim note) segments of the American National Standard Institute (ANSI X12) format or field 390-BM of the National Council for Prescription Drug Program (NCPDP) format. These abbreviations may also be used in Item 19 of the CMS-1500 claim form.”

The changes are effective March 1, 2020, through the end of the PHE.

“This policy change will allow HME suppliers who provide respiratory and infusion services to provide more support to patients and family caregivers during this pandemic,” said Tom Ryan, president and CEO of AAHomecare. “We appreciate CMS’s responsiveness and collaborative approach in modifying regulations to help ensure the HME community can make its strongest possible contribution to limiting the impact of the COVID-19 crisis.”