Change Request Detail
No.
1112
Date
12/8/2010
Submitter
Type of Request
Professional Claim (HCFA 1500)
Status
DSMO Process Completed
Business Reason
Outdated information regarding Certificate of Medical Necessity forms (CMNs) exists in the 837P 5010 Loops 2000B and 2000C in the PAT07 and PAT08.
Suggestion
There are two possible solutions: 1) remove any and all references to actual CMN form numbers in the situational rules of the PAT07 & PAT08 elements to read something to the effect of "Required when patient weight is needed for Medicare Durable Medical Equipment claims. If not required by this implementation guide, do not send." OR 2) remove the situational rule requiring patient weight altogether and allow the patient weight to be captured in the FRM segment similar to the changes made by TG2WG2 related to oxygen billing in Version 4050 of the 837P.
DSMO Category
B
Recommendation
Approve. The DSMO has identified option #1 as submitted as the solution.
Appeal Recommendation