Change Can Be Good

As we have been discussing, there are a number of changes that will be occurring on certificates of medical necessity that will take effect on Oct. 1, 2006, and three more of them are included in this column for the osteogenesis stimulator, TENS unit and seat lift mechanism. These changes are as follows:

• Osteogenesis Stimulator — The osteogenesis stimulator form will change from a DMERC 04.03C to a DME MAC 04.04C. In Section A under “Certification Type/Date,” a recertification field has been added. The blocks for supplier and physician information have both been updated to indicate to ask for an NPI number. In Section B under the “Answers” block, the form now states “Questions 1-5 are blank.” The word “electrical” (in what used to be the first sentence) now reads “nonspinal electrical osteogenesis” and (in what used to be the second sentence) “spinal electrical osteogenesis.” A fourth sentence has also been added that reads, “Answer questions 6 and 12 for ultrasonic osteogenesis stimulator.” Question 6a has been changed and now reads, “In a fracture, has there been no clinically significant radiographic evidence of healing for a minimum of 90 days?” Question 7 has the following words added: “Does the patient have a failed fusion of a joint other than the spine?” Questions 7b and 8 have stayed the same, but Question 9a has the following change: “… repeat single level spinal fusion surgery in a ….” Question 9b has stayed the same. Question 10a has changed in the following way: “… to repeat single level spinal fusion ….” Questions 10b and 10c remain the same. Question 11 now reads, “Is the device being ordered following multi-level spinal fusion surgery?” Question 12 has been added and reads, “Has there been at least one open surgical intervention for treatment of the fracture?” The only other change to this form is that it no longer states that signature and date stamps are not acceptable.
• TENS — The transcutaneous electrical nerve stimulator form will change from DMERC form 06.02B to DME MAC 06.03B. In Section A under “Certification Type/Date,” a recertification field has been added, and the blocks for supplier and physician information have both been updated to indicate to ask for an NPI number. In Section B in the “Answers” block, the wording has changed to read, “Answer questions 1-6 for purchase of TENS.” There are only six questions on the new CMN, but the order has changed from that on the old form. If you can follow this: Question 1 on the new CMN was Question 3 on the old CMN; Question 2 on the new CMN was Question 4 on the old CMN; Question 3 on the new CMN was Question 5 on the old CMN; and Question 4 on the new CMN was Question 6 on the old CMN. Whew! Question 5 on the new CMN was Question 7 on the old CMN, but it has been changed to read, “Has the patient received a TENS trial of at least 30 days?” Question 6 on the new CMN was question 9 on the old CMN. The only other change is that the new TENS form no longer states that signature and date stamps are not acceptable.
• Seat Lift Mechanism — This form changes from DMERC 07.02A to DME MAC 07.03A. In Section A under “Certification Type/Date,” a recertification field has been added, and the blocks for supplier and physician information have both been updated to indicate to ask for NPI number. All of the questions asked are the same as on the old CMN. The only other change is that the form no longer states that signature and date stamps are not acceptable. Because of space constraints, I am unable to discuss the form changes for enteral and parental nutrition and external infusion pumps, but be aware those forms will change from CMNs to DMERC information forms. Make sure you are signed up on the listserv for the Medicare carrier in your region to keep current on the many form changes taking place. Change is sometimes good — but not if you do not know there is change. Until next month, read daily!

Jane Bunch is vice president, HME consulting, for Atlanta-based CareCentric. A reimbursement specialist, Bunch delivers educational seminars worldwide, helps develop corporate compliance plans and serves as a consultant for fraud and abuse cases. She can be reached at 678/264-4495 or via e-mail at [email protected].