Updated 3/30/2023
The CMS-2746 Form (Death Notification) is required by CMS to be submitted in EQRS within 14 days of the patient's date of death (DOD).
MYTH: A signature is required to submit a 2746 Form
FACT: 2728 Forms require signatures
FACT: 2746 Forms require Cause of Death (COD) and Date of Death (DOD) to be submitted
- List of CODs below!
MYTH: Facility needs to wait for the death certificate to submit the 2746 Form
FACT: Facility can select 99 / Unknown if they cannot get the information in 14 days
MYTH: Facility cannot know if the patient has died
FACT: Dialysis facility must 'follow' the patient for 30 days after discharge to know their status - especially if patient is hospitalized
If you need to Submit the 2746 but have lost Scope of the patient (gone for more than 30 days):
- Find the UPI in EQRS
- Go to the Admit page --> Click on the Admit Date --> Delete the Discharge Date & Reason
- Return to the Patient Demographics page --> Click Edit
- Scroll down to the Medical Info section --> Add Date of Death/Cause of Death
- ****The Effective Date needs to be the SAME DATE as the DOD***
- Check the Admit page to make sure that the Discharge info reappears
- Edit the 2746 - the correct information should now appear
COVID-19 Codes:
Form 2746 Death Code | ICD 10 Code | Description | Additional Information |
105 | U07.1 | COVID19 | https://www.cdc.gov/nchs/data/icd/COVID-19-guidelines-final.pdf |
106 | U07.2 | COVID19 Unconfirmed |
The list of ESRD Death Codes can be found on page 2 of the 2746 Form:
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/CMS2746.pdf
