Updated 3/25/2025

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

To add the CAUSE OF DEATH:

Go to the Patient page in EQRS (the main page with the patient info)

Edit (if no Edit button = patient discharged from facility more than 30 days. Remove Discharge Date/Reason in the Admissions Tab, then add back after completing steps below)

Scroll all the way to the bottom of the Patient page.

Update the Cause of Death (COD)

Change the Effective Date to match the Date of Death.

Now the COD it will appear on the 2746 Form.

If you need to Submit the 2746 but have lost Scope of the patient (gone for more than 30 days):

To EDIT a Submitted 2746 Form: https://esrd.ipro.help/hc/en-us/articles/33627852668819-Editing-a-Submitted-2728-Form-2746-Form

COVID-19 Codes:

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