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Resource CMS.GOV Resources

RESOURCES
• CMS 1500
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS1500.pdf
• Electronic Billing & EDI Transactions
https://www.cms.gov/Medicare/Billing/ElectronicBillingEDITrans/index
• Electronic Data Interchange (EDI) Support
https://www.cms.gov/Medicare/Billing/ElectronicBillingEDITrans/EDISupport
• Electronic Health Care Claims Website
https://www.cms.gov/Medicare/Billing/ElectronicBillingEDITrans/HealthCareClaims
• Health Care Payment and Remittance Advice and Electronic Funds Transfer
https://www.cms.gov/Regulations-and...andRemittanceAdviceandElectronicFundsTransfer
• HIPAA Eligibility Transaction System (HETS)
https://www.cms.gov/Research-Statistics-Data-and-Systems/CMS-Information-Technology/HETSHelp
• MAC Website List
https://www.cms.gov/Medicare/Medicare-Contracting/FFSProvCustSvcGen/MAC-Website-List
• Medicare Basics: Parts A and B Claims Overview Video
Medicare Basics: Parts A and B Claims Overview
View attachment 941

• Medicare Billing: Form CMS-1450 and the 837 Institutional Booklet
https://www.cms.gov/Outreach-and-Ed...cts/Downloads/837I-FormCMS-1450-ICN006926.pdf
• Medicare Billing: Form CMS-1450 and the 837 Institutional Web-Based Training (WBT) Course
https://learner.mlnlms.com/Default.aspx
• Medicare Billing: Form CMS-1500 and the 837 Professional Booklet
https://www.cms.gov/Outreach-and-Ed...k-MLN/MLNProducts/Downloads/837P-CMS-1500.pdf
• Medicare Billing: Form CMS-1500 and the 837 Professional Web-Based Training (WBT) Course
https://learner.mlnlms.com/Default.aspx
• Medicare Claims Processing Manual, Chapter 1
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c01.pdf
• Medicare Claims Processing Manual, Chapter 1, Section 80.2.1.2 Payment Floor Standards
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c01.pdf
• Medicare Claims Processing Manual (Pub.100-04), Chapter 24
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c24.pdf
• Medicare Claims Processing Manual (Pub. 100-04), Chapter 25
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c25.pdf
• Medicare Claims Processing Manual, (Pub. 100-04) Chapter 26
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c26.pdf
• Medicare Parts A/B and DME EDI Helplines
https://www.cms.gov/Medicare/Billing/ElectronicBillingEDITrans/Downloads/EDIHelplines.pdf
• New Medicare Beneficiary Identifier (MBI) Get It, Use It
https://www.cms.gov/Outreach-and-Ed...-MLN/MLNMattersArticles/Downloads/SE18006.pdf
• Opioid Treatment Programs (OTP) webpage
https://www.cms.gov/Center/Provider-Type/Opioid-Treatment-Program-Center
• Institutional Paper Claim Form (CMS-1450)
https://www.cms.gov/Medicare/Billing/ElectronicBillingEDITrans/1450
• Professional Paper Claim Form (CMS-1500)
https://www.cms.gov/Medicare/Billing/ElectronicBillingEDITrans/16_1500
• Professional Paper Claim Form (CMS-1500) • Understanding Your Remittance Advice Reports
https://www.cms.gov/files/document/understanding-your-remittance-advice-reports.pdf
• Understanding Your Remittance Advice Reports Medicare Learning Network® Content Disclaimer, Product Disclaimer, and Department of Health & Human Services Disclosure
https://www.cms.gov/Outreach-and-Ed...etwork-MLN/MLNProducts/MLN-Product-Disclaimer :)
 
Click to expand...

CMS is Discontinuing the Use of Certificates of Medical Necessity and Durable Medical Equipment Information Forms for claims with dates of service on or after January 1, 2023.​

Get ready for the coming changes in 2023!
Find out which forms you will not need to complete in 2023.

As part of its ongoing efforts to increase access to care and to reduce the unnecessary administrative burdens for stakeholders, the Centers for Medicare & Medicaid Services (CMS) will be discontinuing the use of Certificates of Medical Necessity (CMNs) and Durable Medical Equipment (DME) Information Forms (DIFs) for claims.

You don’t need to complete these forms for claims with dates of service on or after January 1,
2023:
• CMS-484 – Oxygen
• CMS-846 – Pneumatic Compression Devices
• CMS-847 – Osteogenesis Stimulators
• CMS-848 – Transcutaneous Electrical Nerve Stimulators
• CMS-849 – Seat Lift Mechanisms
• CMS-854 – Section C Continuation Form
• CMS-10125 – External Infusion Pumps
• CMS-10126 – Enteral and Parenteral Nutrition

 
Home Oxygen: 3 New Claims Modifiers

CMS added 3 new modifiers for home oxygen use under national coverage determination (NCD) 240.2 to indicate the appropriate treatment regimen and presence of supporting documentation for each Medicare patient group:

Section B, Group I: modifier N1
Section B, Group II: modifier N2
Section D: modifier N3

Patients under NCD Section B, Group II and Section D have payment and recertification requirements that don’t apply to Group I. The new modifiers are effective January 1, 2023, and will be available in the April 2023 HCPCS code release.

2023-01-05-MLNC | CMS

www.cms.gov www.cms.gov
 
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