Nurse practitioner results
Jim Thelen
Description
Collection
Title:
Nurse practitioner results
Creator:
Jim Thelen
Date:
8/17/2009
Text:
My initial question and responses are detailed below. Thanks to all
that responded. Quite a variety of answers:
Yes to Rx and CMN
No to Rx and CMN
Yes to RX, No to CMN
Question:
I recently had a CMN and RX for diabetic shoes and inserts come through
signed by a nurse practitioner. Can I legally accept it? Patient is
medicare.
Responses:
1. I Pulled up the medicare rule to be sure here it is:
Certificates of Medical Necessity
The Centers for Medicare & Medicaid Services (CMS) requires Certificates of
Medical Necessity (CMNs) and DME Information Forms (DIFs) for certain
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
provided to Medicare beneficiaries. These forms are consistent with current
medical practices and conform to Medicare guidelines.
What Are CMNs and DIFs?
The CMN provides a mechanism for suppliers of durable medical equipment,
defined in 42 U.S.C. Section 1395x(n) and medical equipment and supplies
defined in 42 U.S.C. Section 1395j(5), to demonstrate that the item they
provide meets the minimal criteria for Medicare coverage. The supplier is
required to complete certain sections of the form (Sections A and C) and
then obtain the treating physician's completion and signature of other
sections (Sections B and D). (A treating nurse practitioner, clinical nurse
specialist, or physician assistant may complete Sections B and D and sign
the CMN.)
A DIF is completed and signed by the supplier. It does not require a
narrative description of equipment and cost or a physician signature.
Why are CMNs and DIFs Required?
The supplier must obtain a detailed written order prior to submitting a
claim. A CMN or a DIF is a form required to help document the medical
necessity and other coverage criteria for selected DMEPOS items. For these
items, a supplier must have a signed original, faxed, photocopied or
electronic CMN or DIF in its records before the supplier can submit a claim
for payment to Medicare. Medicare contractors review the documentation
provided on the CMNs and DIFs and determine if the medical necessity and
applicable coverage criteria for DMEPOS have been met.
__________________________________________________________________
2. The RX yes..the diabetic verification form NO.
Only an MD or DO can sign the diabetic verification forms.
MD, DO, DPM plus ARNP and PA-C (if states allow ARNP and PA-C to) can sign
the RXs.
It is silly that the ARNP can prescribe the diabetes prescriptions for the
patient and not sign it, but that is the CMS rule.
3.
The nurse practitioner can sign the Rx if they have their own NPI number.
They can not sign the diabetic statement form.
4.
RX - Yes, CMN - No. CMN can only be signed by a MD or DO.
5.
I have been told as long as they have their own NPI number you can
accept that RX, but if they do not have that number you will have to
get another RX from the MD this NP works under.
6.
yes, as long as he/she has a NPI number
7.
Yes, if they are the practitioner treating the pt. diabetes. It is
podiatrist that can not sign the cmn since they don't treat the diabetes.
This is my interpretation of the law
8.
No. Must be a MD or a DO
Coninued next page.....
Jim Thelen, LPO
Trinidad Medical Consultants
<Email Address Redacted>
214-340-6200
that responded. Quite a variety of answers:
Yes to Rx and CMN
No to Rx and CMN
Yes to RX, No to CMN
Question:
I recently had a CMN and RX for diabetic shoes and inserts come through
signed by a nurse practitioner. Can I legally accept it? Patient is
medicare.
Responses:
1. I Pulled up the medicare rule to be sure here it is:
Certificates of Medical Necessity
The Centers for Medicare & Medicaid Services (CMS) requires Certificates of
Medical Necessity (CMNs) and DME Information Forms (DIFs) for certain
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
provided to Medicare beneficiaries. These forms are consistent with current
medical practices and conform to Medicare guidelines.
What Are CMNs and DIFs?
The CMN provides a mechanism for suppliers of durable medical equipment,
defined in 42 U.S.C. Section 1395x(n) and medical equipment and supplies
defined in 42 U.S.C. Section 1395j(5), to demonstrate that the item they
provide meets the minimal criteria for Medicare coverage. The supplier is
required to complete certain sections of the form (Sections A and C) and
then obtain the treating physician's completion and signature of other
sections (Sections B and D). (A treating nurse practitioner, clinical nurse
specialist, or physician assistant may complete Sections B and D and sign
the CMN.)
A DIF is completed and signed by the supplier. It does not require a
narrative description of equipment and cost or a physician signature.
Why are CMNs and DIFs Required?
The supplier must obtain a detailed written order prior to submitting a
claim. A CMN or a DIF is a form required to help document the medical
necessity and other coverage criteria for selected DMEPOS items. For these
items, a supplier must have a signed original, faxed, photocopied or
electronic CMN or DIF in its records before the supplier can submit a claim
for payment to Medicare. Medicare contractors review the documentation
provided on the CMNs and DIFs and determine if the medical necessity and
applicable coverage criteria for DMEPOS have been met.
__________________________________________________________________
2. The RX yes..the diabetic verification form NO.
Only an MD or DO can sign the diabetic verification forms.
MD, DO, DPM plus ARNP and PA-C (if states allow ARNP and PA-C to) can sign
the RXs.
It is silly that the ARNP can prescribe the diabetes prescriptions for the
patient and not sign it, but that is the CMS rule.
3.
The nurse practitioner can sign the Rx if they have their own NPI number.
They can not sign the diabetic statement form.
4.
RX - Yes, CMN - No. CMN can only be signed by a MD or DO.
5.
I have been told as long as they have their own NPI number you can
accept that RX, but if they do not have that number you will have to
get another RX from the MD this NP works under.
6.
yes, as long as he/she has a NPI number
7.
Yes, if they are the practitioner treating the pt. diabetes. It is
podiatrist that can not sign the cmn since they don't treat the diabetes.
This is my interpretation of the law
8.
No. Must be a MD or a DO
Coninued next page.....
Jim Thelen, LPO
Trinidad Medical Consultants
<Email Address Redacted>
214-340-6200
Citation
Jim Thelen, “Nurse practitioner results,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/230652.
