Wheelchair CMNs – Transition Instructions
On August 21, 2005 the Centers for Medicare and Medicaid Services (CMS) announced its plan to eliminate use of Certificates of Medical Necessity (CMNs) for manual wheelchairs, power operated vehicles (POVs), power wheelchairs, and related accessories. This applies to claims with dates of service on or after May 5, 2005, the effective date of the new National Coverage Determination (NCD). Because of the need for major system changes by CMS, this cannot be fully implemented until April 2006. Until then, suppliers must submit partially completed CMNs with initial claims for these items.
Effective for claims with dates of service on or after 5/5/05 that are received on or after October 1, suppliers may follow these instructions concerning the submission of CMNs for manual wheelchairs, POVs, and power wheelchairs:
The physician does not need to review, complete or sign any part of the CMN.
For CMNs that are transmitted electronically:
- Section A: Enter the “date of service” (i.e., the delivery date) in the “Initial” date field.
- Section A: Enter information in all required fields as is currently being done, including HCPCS codes for the wheelchair base and all accessories which require a CMN.
- Section B: Enter 99 in the “Est. Length of Need” field.
- Section B: Enter the primary diagnosis in the “Diagnosis Codes” field.
- Section B: Enter “D” as the answer to all questions. Exception: Enter “24” for question #5 on the manual wheelchair and power wheelchair CMNs.
- Section C: Leave blank.
- Section D: Enter a “Yes” in the “Physician’s Signature” field. Enter 5/5/05 in the “Signature Date” field.
For CMNs that are sent hard copy, only complete section A. All other sections of the CMN should be left blank.