Podiatry Coding & Billing Alert
Alter CNMs and Risk Committing Fraud
Question: My billing supervisor erased something that the doctor wrote on a certificate of medical necessity (CMN) for some durable medical equipment (DME) and replaced it with something else before the paperwork was submitted to Medicare. I even had a previous supervisor say that was an acceptable practice and no big deal. Is this fraudulent? Montana Subscriber Answer: If a CMN is altered by anyone who is not the physician who wrote it, it may be considered fraudulent. “If there is a change made to any section of the CMN after the physician has signed the CMN, the physician must line through the error, initial and date the correction; or the supplier may choose to have the physician complete a new CMN,” the Medicare Program Integrity Manual says in Chapter 5. It could cause problems for the DME company as well, particularly if it’s audited. Bottom line: Adjusting a CMN if you’re not the physician who wrote it doesn’t comply with Medicare’s (and most other payers’) rules.
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Alter CNMs and Risk Committing Fraud
Question: My billing supervisor erased something that the doctor wrote on a certificate of medical [...]
