decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
DME Model Compliance Plan / Risk Areas / Certificate of Medical Necessity (CMN)
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Article Overview
This article reviews a durable medical equipment compliance topic centered on Certificates of Medical Necessity and supplier responsibilities. It is aimed at DME suppliers, compliance staff, and billing professionals who need a general understanding of documentation, retention, and ordering requirements tied to Medicare reimbursement. The article also references government guidance and forms associated with selected equipment categories and discusses policy considerations for preventing documentation and submission risks.
Why This Topic Matters
Understanding CMN-related documentation and supplier controls is important for organizations that bill Medicare for DME because the article addresses compliance exposure, record retention, and internal policy practices connected to these claims.
Article Sections
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Certificate of Medical Necessity requirements for DME
Introduces the CMN framework as it relates to durable medical equipment and identifies the broad equipment categories covered by the article. It also notes the government sources and forms connected to this documentation process.
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Retention, completion, and signature requirements
Summarizes the article’s discussion of recordkeeping, form completion responsibilities, and signature handling for CMNs. This section also addresses the role of supplier policies and procedures in supporting compliance.
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OIG recommendations for supplier policies and procedures
Covers the compliance-oriented policy areas highlighted by the article for DME suppliers. It focuses on documentation controls, claim timing, and internal safeguards discussed in connection with CMN workflows.
What You Will Learn
- How CMNs relate to certain durable medical equipment claims
- Which broad DME categories are discussed in connection with CMN requirements
- What supplier recordkeeping and form-handling topics the article emphasizes
- What types of compliance controls are highlighted for DME supplier policies
Who Should Read This
- Durable medical equipment suppliers
- Medical billing and coding professionals
- Healthcare compliance staff
- Revenue cycle teams
- Provider office staff involved in DME documentation
Codes Discussed
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