Can a CPAP CMN still be utilized to support medical necessity for PAP devices?
No. This form has been discontinued and should never be used. Providers of service should obtain a detailed written order and a copy of the sleep study to ensure correct use of the KX modifier for the first three months billing and an affirmation the patient was re-seen and evaluated by their treating physician no sooner than the 31st day and no later than the 91st day. This re-evaluation must include confirmation of compliance with using the PAP device. Without this affirmation, the 4th months claim should not be submitted until the patient has been re-evaluated and found in compliance.
