Use of inactive or “retired” CMNs will not be recognized by Cigna for either medical necessity purposes or as a substitute for a written order

Suppliers often create forms to facilitate gathering medical necessity information and ordering durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), calling them “Certificates of Medical Necessity.” While supplier-created forms are generally not prohibited, suppliers must also recognize that a Certificate of Medical Necessity (CMN) is a specific Medicare term that describes an Office of Management and Budget (OMB)-approved form created by the Centers for Medicare and Medicaid Services (CMS). CMS is required to review and update the forms on a periodic basis and receive approval from the OMB in order to continue their use.

Only OMB-approved, active CMNs that are in use for the date of service on the claim under consideration for reimbursement will be recognized by CIGNA Government Services (CGS) in support of medical need or, when completed properly, as a substitute for a written order. Use of inactive or “retired” CMNs will not be recognized by CGS for either medical necessity purposes or as a substitute for a written order.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: