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CMS Updates the Standard Documentation Requirements Policy Article -- Effective Jan. 1, 2023

Source: American Association for Homecare


Earlier this week, CMS published the new Standard Documentation Requirements for All Claims Submitted to DME MACs that goes into effect beginning 1/1/23. The future effective policy article updates the references to the certificate of medical necessity (CMN) & DME information form (DIF), noting that CMN and DIF are only required for certain items prior to 1/1/23, and they will not be accepted beginning 1/1/23.  CMS further clarifies that if suppliers submit claims with a CMN or DIF when it is not needed, the claim will be rejected, effective 1/1/23.

The future effective policy article also states that a recent order/prescription by the treating practitioner will meet continued need requirements for repairs. This is a big win for suppliers that provide PMD and other capped rental items. Current policy requires repairs to be noted in the medical record. AAHomecare is pleased to see the DME MACs listened to members and made this change.

** Program Note:  CGS and Noridian Provider Outreach and Education (POE) team is hosting a collaborative Ask-the-Contractor call on the elimination of CMNs and DIFs on Thursday, December 8, at 2 pm ET/1 pm CT. POE will briefly provide information related to any Medicare news or updates. Then the phone lines will open for attendees to ask questions on the elimination of CMNs and DIFs. Reserve your spot today!

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