Certificate of Medical Necessity
Also written as: CMN — Certificate of Medical Necessity
A formal document completed by a prescribing physician attesting that a prescribed prosthetic device is medically necessary for a specific patient.
Full Definition
A Certificate of Medical Necessity (CMN) is a standardized form required by Medicare and other payers to authorize reimbursement for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). In the context of prosthetic services, the CMN must specify the patient's diagnosis, amputation level, functional classification, and the prescribed device. Editors handling CMN documents must ensure that all fields are completed, that the language of medical necessity is unambiguous, and that no contradictions exist between the CMN and the accompanying Letter of Medical Necessity. The acronym 'CMN' should be expanded on first use.
Usage
Usage note: Not interchangeable with 'Letter of Medical Necessity.' The CMN is a standardized payer form; the LMN is a narrative clinical document. Both may be required simultaneously.
In Context
- "The auditor rejected the claim because the Certificate of Medical Necessity did not include a documented functional classification level." — Medicare audit response
- "Expand 'CMN' to 'Certificate of Medical Necessity' on first use in any formal submission to a payer." — Editorial checklist for reimbursement documents