[Brian Hagan]

When changing a patient over form Portable tanks E0431 to the Portable Concentrator E1392, do you need to bill that as a revised CMN or start them on an initial?

[Sleeping410]

From the Medicare LCD

MISCELLANEOUS:

In the following situations, a new order must be obtained and kept on file by the supplier, but neither a new CMN nor a repeat blood gas study are required:

• Prescribed maximum flow rate changes but remains within one of the following categories: (a) less than 1 LPM, (b) 1-4 LPM, (c) greater than 4 LPM.
• Change from one type of stationary system to another (i.e., concentrator, liquid, gaseous).
• Change from one type of portable system to another (i.e., gaseous or liquid tanks, portable concentrator, transfilling system).

A new CMN is not required just because a patient changes from Medicare secondary to Medicare primary.

A new CMN is not required just because the supplier changes assignment status on the submitted claim.

Suppliers are reminded that in an audit they may be asked to provide a copy of the actual test report and/or information from the medical record to verify that coverage criteria have been met.

Refer to the Supplier Manual for more information on documentation requirements.