The CMN is one of the documents Medicare, Medicaid, and Private Insurance Companies use to evaluate the need for power mobility equipment.  The evaluation is based on the length of need of the item, the diagnosis codes used to prescribe the product, and the answers provided to questions 1-7 (Power Wheelchair) or 6-14 (Electric Scooter).  Reimbursement for power wheelchairs and scooters is contingent on the CMN being completed accurately.  Please use the diagram below as a reference in completing the the Certificate of Medical Necessity.  Questions and directions are also provided on the reverse side of the CMN or on an additional page that has been faxed to your office.

Power Wheelchairs

1. Most common mistakes when completing a CMN (Power Wheelchairs and Scooters): The CMN is written in very small font and a section can be easily missed. To make sure the CMN is completed, go though and make sure you filled in 3 areas and answered 7 question in Section B (see section B) and you have signed and dated the CMN in Section D.

2. Incorrect ICD-9 Codes: The ICD-9 codes need to be complete.  Most codes have either a fourth or fifth digit that can be easily omitted.  Without this digit, the code is incomplete and Medicare is unable to process the CMN. If this happens the CMN must be returned to the doctor’s office and completed again. This causes delays and increases workload on the doctor’s office.

3. Lack of ICD-9 Codes Explaining All of Patients Ailments:  Use as many codes as possible to explain the patient’s condition.  Without a full explanation of the patient’s condition Medicare might reject the claim as not medically necessary.

4. Lack of Documentation that Supports need of a Power Wheelchair:  The Certificate of Medical Necessity must be accompanied by supporting documentation. This documentation must show the need for a power wheelchair. The supporting documents should be one of the following: Patient’s chart notes, Letter of Medical Necessity or Evaluation of the Patient’s medical and physical condition.

***If the prescribing doctor makes a mistake on the CMN, the changes must be both initialed and dated***

Electric Scooters