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CMS clarifies oxygen requirements 

CMS clarifies oxygen requirements 

WASHINGTON – CMS has posted a joint DME MAC publication clarifying that certificates of medical necessity are not required for oxygen claims during the public health emergency. 

The publication also clarifies that DME Information Forms are not required for external infusion pumps during the PHE. 

“CMS-1744-IFC (an interim final rule issued April 6, 2020) stated that CMS would exercise enforcement discretion for clinical indications of coverage for the oxygen NCDs and LCDs during the PHE,” the publication states. “Numerous fields on the CMN for oxygen are directly related to the clinical indications. 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. The same concerns that apply to the oxygen CMN also apply to the External Infusion Pump (EIPs) DIF; therefore, the requirements for a DIF for EIP claims will also not be enforced.” 

Use of the CR modifier and COVID-19 narrative reflects claims submitted during the PHE, according to the publication.


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