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Submitting Oxygen Certificates of Medical Necessity Electronically When an Arterial Blood Gas or Saturation Test is Not Present

Suppliers submitting oxygen Certificates of Medical Necessity (CMNs) electronically when the arterial blood gas (ABG) test (question 1a) or oxygen saturation test (question 1b) was not performed and are not present on the CMN, should not submit the applicable question (1a or 1b) in their electronic submission.

National Government Services has seen claims submitted with a zero value in question 1a or 1b on the electronic oxygen CMN causing the claim to edit for manual review and possibly denying for missing CMN information. This happens because the date submitted in question 1c (2440.FRM04) is included and results submitted had a value of zero. When an ABG or saturation test was not performed and is not present on the CMN, suppliers should not submit the applicable question 1a or 1b (2440.FRM01) electronically.

This is an example of how the oxygen CMN would be sent electronically in the American National Standards Institute (ANSI) format when an ABG test is not present on the CMN:

LQ*UT*48403~
FRM*1B****89~
FRM*1C***20120115~

Suppliers would only submit the results for question 1b and the date of the test in question 1c. Question 1a would not be sent in the electronic submission.

This is an example of how the oxygen CMN would be sent electronically in the ANSI format when a saturation test is not present on the CMN:

LQ*UT*48403~
FRM*1A**49~
FRM*1C***20120115~

Suppliers would only submit the results for question 1a and the date of the test in question 1c. Question 1b would not be sent in the electronic submission.

If the CMN has both an ABG and saturation test listed, supplier should report both in the electronic format. Below is an example of how this would be sent in the ANSI format:

LQ*UT*48403~
FRM*1A**49~
FRM*1B****89~
FRM*1C***20120115~

Supplier would submit the results for question 1a and 1b, along with the date of the test in question 1c.

If you have specific questions on how to enter this information correctly into your system, contact your software vendor directly.

Submitting Oxygen CMNs Electronically When an ABG or Saturation Test is Not Present
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