tci Medicare Compliance & Reimbursement - 2024 Issue Q1

Reader Question: Understand These CMN Basics

Question: My billing supervisor erased data that the doctor wrote on a certificate of medical necessity (CMN) for some durable medical equipment (DME) and replaced it with something else before the paperwork was submitted to Medicare. I even had a previous supervisor say that was an OK practice and not a big deal. Is this fraudulent? Minnesota Subscriber Answer: Yes, if a CMN is altered by anyone who is not the physician who wrote it, it may be fraud. “If there is a change made to any section of the CMN after the physician has signed the CMN...

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