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Certificate of Medical Necessity

Looking for Medical Device or Braces checks?  Look no further!  pVerify now has A,E,B and K codes in addition to L codes service (our Same/Similar service).  The new pVerify service Certificate of Medical Necessity (CMN) claim history for Medical Devices will process A,E,B, and K codes associated with medical devices.  It will then return claim history for the patient for entered codes, to identify if the patient is eligible for a new device.

CMN through pVerify allows users to view payable Certificates of Medical Necessity (CMNs) for specific beneficiaries, for specific Healthcare Common Procedure Coding System (HCPCS) codes. This will provide the following information when a same or similar HCPCS code is found in the common working file or the DME Jurisdiction’s local records:

  HCPCS code and modifier

  Last day the item was billed

  Initial date on file

  Supplier name

  Recertification date (if applicable)

  Supplier phone number

CMN through pVerify  will search and provide status on these types of items:

  Oxygen

  Pneumatic compression devices

  Osteogenesis stimulators

  Transcutaneous electrical nerve stimulators (TENS)

  Seat lift mechanisms

  Enteral/ parenteral nutrition

  External infusion pumps

  Respiratory items

  Hospital beds

  Mobility devices

Here’s how it works:

You submit a batch of patients or type the patient into our portal. Then you can get an instant response showing detailed history for that claim, or a file showing claim responses for your batch patient list.

 

 
Example of a patient with a successful claim.
 

 
CMN Dashboard View.