Clarification: Certificate of medical necessity required for only seat lift mechanism

In the January issue of The Record, in the article titled “Medicare Advantage durable medical equipment coverage changes,” we reported that a certificate of medical necessity was required for patient lifts. The CMN requirement is only for the seat lift mechanism portion of what is commonly referred to as a lift chair.

A CMN is a form the physician must complete and submit with a DME prescription. It certifies the member’s condition is such that the DME being prescribed is medically necessary. If a DME supplier bills for items requiring a certificate of medical necessity, the supplier must bill with the KX modifier to indicate a certificate is on file.

We apologize for any confusion this may have caused. If you have any questions, please contact your provider consultant.