CMS Clarifies Ordering & Certifying Documentation Requests

CMS has issued Change Request (CR) 9114 that provides instructions and clarification on their existing policy for ordering and certifying maintenance requirement.

In May 2010, CMS issued an interim final rule (CMS-6010-IR) and on April 27, 2012, a final rule (CMS-6010-F) which established Medicare Ordering and Referring, and Documentation Maintenance Requirements.

CMS required that any provider and supplier that furnishes covered home health services, items of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), clinical laboratory, or imaging services, is required to maintain documentation for 7 years from the date of service, and that the provider give access to that documentation upon request. This requirement also applied to a physician ordering/certifying home health services, items of DMEPOS, clinical laboratory, or imaging services.

In the CR, CMS clarifies the term “access to documentation” to mean that the documentation is actually provided or made available in a the manner requested by CMS or a Medicare contractor. CMS provides examples of sufficient and deficient access to documentation in the CR.

Click here to view the CR.

Click here to read more.


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