CMN forms are only required on 5 items — Oxygen / Tens units (purchase) / Seat lift mechanisms/ Osteo genises Stims & Lymphadema pumps — What suppliers are calling CMNs are really just an order for the doctor to review and sign off on. It is important to realize that this should not be something that you just print off from your computer system. There needs to be something explaining from whom the order came/ their title / date and time. this means that a physicians office/snf/hospital discharge or someone called/faxed or electronically sent you a request for an item for a specific patient. Each jurisdictions has an exact description of a dispensing order and a detailed written order as well as WOPD (written order prior to deliver) {which is required on certain items)
Ron Bendell
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Stay up to date with VGM’s latest offerings and what we are working on for you. I’ll keep you posted on industry issues. I value your feedback!
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John Gallagher
- Compliance
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Stay informed on the latest developments concerning Competitive Bidding and it’s affect on both the consumers and the HME industry.
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Mark Higley
- Compliance
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Inaccuracies in Medicare payments cost the consumer and the HME industry millions of dollars in time and profit. Learn about the latest steps being taken correct these issues.
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Kelly Turner
- Compliance
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Competitive bidding is happening in your area now or in the near future. Learn how you can become an advocate for local HME users and dealers.
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Peggy Walker
- Compliance
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Compliance in the HME industry can make or break an HME provider and its affects are felt by everyone. Peggy Walker shares news, tips and insight into this important topic.
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have patient that is 512 lbs and 5’6″ bed bound and needs support surface for stage 2 on lower coccyx. Has not had an prior support surfaces. Do I need to try anything else out on the patient like a GO or APP, or do I skip to the LAL and how do I prove that to Medicare?
To go to a group 2 surface you must meet all criteria first. Multiple stage 2s – group 1 etc.
Peggy,
On custom lymphedema garments, A patient must be measured for the garment is that billable or just the garment billable.
You only bill the garment. Just measuring is not an option. These come in small / medium/ large etc. Custom means you make it to fit the patient. Not just measuring.
When can you bill an E1220?
This code would not be billed to Medicare – this is usually for Medicaid or private insurance.
WE DID NOT GET A BID FOR O2 ROUND 1 WE HAVE A PATIENT THAT HAS A MEDICARE ADVANTAGE PLAN NOW AND WANTS TO CHANGE O2 SUPPLIERS NOW BUT THIS PT WILL BE CHANGING TO TRADITIONAL MEDICARE JAN 1 CAN WE CONTINUE WITH THIS AS A GRANDFATHERED PT AND BILL MEDICARE FOR THE O2 IN JANUARY
If you did not get the bid you can’t bill Medicare unless you informed them up front that you were going to grandfather all your patients.
Peggy
I AM GRANDFATHERING ALL MY PATIENTS THIS PT WANTS TO CHANGE TO US NOW AT THIS TIME SHE HAS A MEDICARE ADVANTAGE PLAN BUT WILL BE SWITCHING TO TRADITIONAL MEDICARE IN JANUARY SO WILL I BE ABLE TO GRANDFATHER HER NOW SAME AS WE DID AT THE BEGINNING OF COMPETITVE BIDDING
You could only grandfather existing patients so if she your existing patient?
SHE WILL BE IF I SET HER UP THIS MONTH AS SHE WANTS UNDER THE ADVANTAGE PLAN
She is on the Advantage plan and you are going to take her on now. Then she transfers into the fee for service Medicare plan as your patient? If the patient is your patient when she moves into Medicare than you can GF her.