DMERC - Professional

The Durable Medical Equipment Certification (DMERC) section is used to supply information regarding a physician’s certification for durable medical equipment. The DMERC fields are defined by section below:

DME Certification Information: The DME Certification Information section is used to supply information regarding a physician’s certification for durable medical equipment.

Attachment Transmission CodeAttachment Transmission Code

Code defining timing, transmission method or format by which an attachment report is to be sent or has been sent.

AB	Previously Submitted to Payer
AD	Certification Included in this Claim
AF	Narrative Segment Included in this Claim
AG	No Documentation is Required
NS	Not Specified (Paperwork is available on request at the provider's site. This means that the paperwork is not being sent with the claim at this time. Instead, it is available to the payer (or appropriate entity) at their request.)

Revision DateRevision Date

Certification revision recertification date.

Last Certification Date Last Certification Date

The date the ordering physician signed the CMN or Oxygen Therapy Certification, or the date the supplier signed the DMERC Information Form (DIF).

Begin Therapy DateBegin Therapy Date

A date, a time, and a range of dates, times, or dates and times in which DME therapy begins.

Certification Type CodeCertification Type Code

Code indicating the type of certification. Options are:

I	Initial
R	Renewal
S	Revised

DME DurationDME Duration

Length of time DME equipment is needed.

Procedure CodeProcedure Code

Code identifying the procedure, product or service.

Length of Medical NecessityLength of Medical Necessity

Number of days the durable medical equipment will be required for medical treatment.

DME Rental PriceDME Rental Price

Rental price of the Durable Medical Equipment. Used in conjunction with the Rental Unit Price Indicator.

DME Purchase PriceDME Purchase Price

Purchase price of the Durable Medical Equipment.

Rental Unit Price IndicatorRental Unit Price Indicator

Frequency at which the rental equipment is billed. Used in conjunction with the DME Rental Price.

1	Weekly
4	Monthly
6	Daily

Form Identification Code QualifierForm Identification Code Qualifier

Code list qualifier code. Code identifying a specific industry code list. Options are:

AS	Form Type Code
UT	Centers for Medicare and Medicaid Services (CMS) Durable Medical Equipment Regional Carrier (DMERC) Certificate of Medical Necessity (CMN) Forms

CodeCode

Code indicating a code from a specific industry code list. Form Identifier.

Certification Condition IndicatorCertification Condition Indicator

Code indicating whether or not the condition codes apply to the patient or another entity. Options are Yes or No.

Condition Indicator Condition Indicator 1

Options are:

38	Cert on file at the supplier's office
ZV	Replacement item

Condition Indicator Condition Indicator 2

Options are:

38	Cert on file at the supplier's office
ZV	Replacement item

Provider is Employed by HospiceProvider is Employed by Hospice

Yes/No condition or response code.

Supporting Documentation Information: The Supporting Documentation Information section represents answers to a coded document that contains specific questions.

Question NumberQuestion Number

Identifies the question or letter number.

Response Code Response Code

Code indicating a condition or response. Options are:

N	No
W	Not Applicable
Y	Yes

ResponseResponse

A yes/no question response.

DateDate

Required when question identifies uses a date response format.

PercentPercent

Percent given in decimal format. Required when question identified uses a percent response format.

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Measurement Information: The Measurement Information section is used to specify physical measurements or counts, including dimensions, tolerances, variances, and weights.

Measurement IDMeasurement ID

Code identifying the broad category to which a measurement applies. Options are:

OG	Original (use to report Starting Dosage)
TR	Test Results

Measurement QfrMeasurement Qfr

Code identifying a specific product or process characteristic to which a measurement applies. Options are:

HT	Height
R1	Hemoglobin
R2	Hematocrit
R3	Epoetin Starting Dosage
R4	Creatine

Test ResultsTest Results

The value of the measurement or test results.

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