Submit a New CMN When Adding Portable O2

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:
    1. Less than 1 liters per minute (LPM)
    2. 1-4 LPM
    3. 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.

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Brad Ericson

Brad Ericson

Publisher at AAPC
Brad Ericson, MPC, CPC, COSC, has been publisher for more than nine years. Before AAPC he was at Optum for 13 years and at Aetna Health Plans before that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.
Brad Ericson

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Brad Ericson, MPC, CPC, COSC, has been publisher for more than nine years. Before AAPC he was at Optum for 13 years and at Aetna Health Plans before that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.

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