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CSA 052920A
May 29, 2020
DME MACs and CMS COVID-19 Updates
Dear Valued Customer,

Change Healthcare is committed to keeping you informed regarding the ongoing publications related to COVID-19. The details are rapidly changing, and these CSAs are one way we are sharing the details that pertain specifically to our pharmacy customers.

This notification is to inform you of the following items recently published by CMS, HHS, and the DME MACs as they relate to pharmacies.  

Also included is an outline of previously published notifications to help consolidate all COVID-19 items into one reference guide.

        (The below details contain content directly from publications provided from the above sources)

New / Updated Items of Interest

1.   Signature Requirements on Proof of Delivery During the COVID-19 Pandemic

Revised 05.21.20 - Added language to include the use of the CR modifier and COVID-19 narrative if the claim is affected by the COVID-19 PHE.

In response to the COVID-19 pandemic CMS is waiving signature requirements on proof of delivery (POD) documentation, for Dates of Service (DOS) within the Public Health Emergency (PHE) for the COVID-19 pandemic. Given the nature of the pandemic and the inability to collect signatures during this time, CMS will not be enforcing the signature requirement.

Items of DMEPOS that are delivered directly to the beneficiary by the supplier (Method 1) typically require a beneficiary's (or designee) signature on the delivery document. During the PHE, suppliers should document the appropriate date of delivery and that a signature was not able to be obtained because of COVID-19.

Suppliers are reminded to append a CR modifier and include a narrative of "COVID-19" to all claims that are affected by the COVID-19 PHE, including situations like that described above where a signature is not able to be obtained on a POD document.

Method 2 proof of delivery via shipping or delivery service does not require a signature from the beneficiary or designee; however, it does require evidence of delivery. Please review here the Standard Documentation Requirements for All Claims Submitted to DME MACs (A55426) Policy Article for complete information on proof of delivery documentation requirements.

2.  Oxygen and Infusion Pumps: CGS and Noridian COVID-19 Claims that were Submitted Without a Certificate of Medical Necessity or DME MAC Information Form (DIF) and Denied

With the recent COVID-19 Public Health Emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) is allowing Medicare beneficiaries to obtain DME oxygen equipment without a Certificate of Medical Necessity (CMN) for oxygen and without a DME MAC Information Form (DIF) for external infusion pumps.

This includes claims affected by the COVID-19 PHE and is for claims for dates of service beginning March 1, 2020 through the duration of the PHE.

The claim should be submitted with CR modifier and COVID-19 as the narrative.

If the claim is denied due to a missing CR modifier or narrative these claims can be corrected with Noridian and CGS as Written Reopenings. Noridian will also accept these claims through Telephone Reopenings.
Previously Published CSAs Related to COVID-19

Change Healthcare continues to monitor this rapidly evolving situation and will provide updates as circumstances change.

Change Healthcare is proud to be your business partner and remains committed to your success. 

Thanks for your attention to this announcement,

Change Healthcare
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