Electronic Claims Attachments

Claim attachments are supplemental documents providing additional medical information to the claims processor that cannot be accommodated within the claim format. Common attachments are Certificates of Medical Necessity (CMNs), discharge summaries and operative reports. They are sent to the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) and/or A/B MAC with the original claim or in response to a request from a DME MAC or A/B MAC.

On September 23, 2005 a Notice of Proposed Rule Making (NPRM) was published in the Federal Register announcing proposed standards for six types of electronic claims attachments and the standard to be used by health benefit plans to request an attachment and identify the type of information that is needed. A copy of the implementation guide proposed in that NPRM as the national standard for these attachments is available without cost at the official Washington Publishing Company website.

There is a link to the NPRM available through a separate CMS web page. Instructions and the deadline for submission of NPRM comments and actions to be taken by CMS once that comment closes is included on that page.