Submit a New CMN When Adding Portable O2
By Brad Ericson, MPC, CPC, COC
National Government Services, the Jurisdiction B durable medical equipment (DME) administrative contractor, has seen an increase of incorrect Certificate of Medical Necessity (CMN) submissions when a portable oxygen system is added subsequent to the initial certification of a stationary system. When this occurs, they remind you should submit a revised CMN and not an initial CMN. The local coverage determination (LCD) outlines when you should submit a revised CMN:
- When the prescribed maximum flow rate changes from one of the following categories to another:
- Less than 1 liters per minute (LPM)
- 1-4 LPM
- Greater than 4 LPM
- If the change is from category (a) or (b) to category (c), a repeat blood gas study with the beneficiary on 4 LPM must be performed.
- When the length of need expires – when the physician specified less than lifetime length of need on the most recent CMN
- When a portable oxygen system is added subsequent to initial certification of a stationary system
- When a stationary system is added subsequent to initial certification of a portable system
- When there is a new treating physician but the oxygen order is the same
- If there is a new supplier and that supplier does not have the prior CMN
As a reminder: submission of a revised CMN does not change the recertification schedule specified above. If the indications for a revised CMN are met at the same time that a recertification CMN is due, file the CMN as a recertification CMN. This reminder is a good one, despite your jurisdiction.