Archived Form 2746

The ESRD Death Notification Form (CMS-2746) is a one-time form completed when a dialysis patient dies. The purpose of the form is to notify Medicare of the date and cause of a patient's death. The 2746 form is to be completed by the transplant or dialysis center that was last responsible for the care of the patient on an ongoing basis, regardless of the place of death.

Form CMS 2746 ICD Codes and COVID-19 Deaths
Please be advised that CMS has added death codes (COD, Cause of Death) to the CMS 2746 form in EQRS specifically to capture deaths related to COVID-19. ...
Tue, May 17, 2022 at 11:13 AM