Yesterday, the DME MACs announced that the CMN for oxygen claims will not be required during this Public Health Emergency. This is due to the CMS interim final rule that was published on April 6 (CMS-1744-IFC) that waived the clinical indication requirements for respiratory NCDs and LCDs. In the new announcement, the DME MACs clarified that the same exemption will apply to external infusion pumps. These changes are effective for dates of service starting March 1, 2020, through the end of the public health emergency.

The DME MACs explained how DME suppliers should file oxygen (and external infusion pump) claims without a CMN:

Suppliers should continue to use the appropriate modifiers, including the KX modifier where applicable, for all HCPCS codes included in the [relevant] NCDs and LCDs. In addition, the CR modifier (CATASTROPHE/DISASTER RELATED) should be added to the HCPCS code(s) billed. Finally, suppliers are instructed to enter "COVID-19" in the NTE 2400 (line note) or NTE 2300 (claim note) segments of the American National Standard Institute (ANSI X12) format or field 390-BM of the National Council for Prescription Drug Program (NCPDP) format. These abbreviations may also be used in Item 19 of the CMS-1500 claim form.

This announcement comes after extensive discussions AAHomecare had with CMS. See the full announcement here .

"This policy change will allow HME suppliers who provide respiratory and infusion services to provide more support to patients and family caregivers during this pandemic," said Tom Ryan, AAHomecare President and CEO. "We appreciate CMS's responsiveness and collaborative approach in modifying regulations to help ensure the HME community can make its strongest possible contribution to limiting the impact of the COVID-19 crisis."

 

As many of you know, the DMD's of all four DME MAC jurisdictions published a joint bulletin article related to CMS-1744-IFC and CMS-5531-IFC yesterday, May 7.

You can find that article on the Noridian websites in the following locations:

Many of the questions we have been awaiting answers on are addressed in this article. Additionally, Noridian is working with CGS to schedule another collaborative webinar to disseminate updated information and allow for questions. Please watch for the webinar registration link to be posted on our Schedule of Events . We are planning for noon CT on May 14 (registration link coming soon) which will then be followed by the   Noridian Respiratory Ask the Contractor Teleconference . This will offer you two opportunities to have questions answered as we move forward in our understanding of the waivers and flexibilities allowed by CMS.

 

Thank you and have a great weekend. We look forward to "seeing" you on our events next week.

 

Stay up-to-date on Medicare decisions regarding the current COVID-19 pandemic by viewing our Emergencies and Disasters page on our website.

JA Emergencies and Disasters

JD Emergencies and Disasters

 

Noridian DME Outreach and Education

NORIDIAN HEALTHCARE SOLUTIONS, LLC

www.noridian.com | www.noridianmedicare.com

The Webinar will be on Thursday, May 21 @ 1:00 pm PDT 

(3:00 pm CDT / 4:00 pm EDT) 

• A Philips Respironics rep and a DME owner will discuss best practices and efficiencies.
• Mark Higley will speak about states that are beginning to open up for business, what to expect, and steps that should be taken.
• Craig Douglas will summarize the various economic stimulus packages and loan programs available to providers and offer important updates regarding some of the programs.
• Ronda Buhrmester will speak about the CARES Act and the non-rural rate increase, as well as an overview of which policies are temporarily suspended.
• Will include a CAMPS update on Medi-Cal.