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The document is a Certificate of Medical Necessity (CMN) form (CMS-847) for osteogenesis stimulators, issued by the Centers for Medicare & Medicaid Services. It outlines the required information for certifying the medical necessity of these devices, including patient and supplier details, diagnosis codes, and specific questions regarding the patient's condition. The form must be completed by both the supplier and the treating physician to ensure compliance with Medicare regulations.

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What does a Certificate of Medical Necessity look like?

Sample Format Letter of Medical Necessity [Insert Patient Name] has been under my care for [Insert Diagnosis] [Insert ICD-10-CM or ICD-11-CM code] since [Insert Date]. Treatment of [Insert Patient Name] with [medication] is medically appropriate and necessary and should be covered and reimbursed.

How long is CMN valid for?

CMNs are valid for 1 year as dictated by individual state law.

What is a CMN Medicare form?

A certificate of medical necessity (CMN) is documentation from a doctor which Medicare requires before it will cover certain durable medical equipment (DME). The CMN states the patients diagnosis, prognosis, reason for the equipment, and estimated duration of need.

Is the CMN no longer required?

CMS eliminates requirement for CMNs and DIFs 02.27. 2023.

What is CPT code E0747?

An ultrasonic osteogenesis stimulator (E0760) is covered only if all of the following criteria are met: Nonunion of a fracture documented by a minimum of two sets of radiographs obtained prior to starting treatment with the osteogenesis stimulator, separated by a minimum of 90 days.

What is a proof of medical necessity?

Your doctor or other provider may be asked to provide a Letter of Medical Necessity to your health plan as part of a certification or utilization review process. This process allows the health plan to review requested medical services to determine whether there is coverage for the requested service.

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