[KarenH]

We have a patient that was using a stationary oxygen unit with her CPAP. Now she requires a portable system. The new initial CMN for portable continued to be disregarded by Medicare.

When I called, I was told the CMN has been received and is in an "informational status" and has not officially been loaded.

It appears Medicare had an initial CMN for a portable system back in 2004. The representative told me the CMN may deny since there is a previous initial on file. If that is the case, I may have to resubmit a renewal with the matching initial date and use an RA modifier notating in the comments of a break in service. - from 7+ years ago.

Is it just me or are others running into these wacky scenarios? I have not heard about this "informational status" designation for incoming cmn's either, can anyone shed some light for me? I understand a break in service within the 36 months needs to be addressed but 7+ years?

Karen

[KarenH]

Once again, it denied for no prescription. I suppose I will have to address the break in service from 7 1/2 yrs ago.

[Regina]

Karen-
I am just seeing your post, but noticed that no one had answered. I think we are probably all as befuddled as you are. But since, you received another denial, I think you probably need to send to review, or use the RA modifier as the rep suggested. They are so good at finding new ways to delay payment!