CMS Announces Appeals Manual Update

June 27, 2013

The Centers for Medicare & Medicaid Services (CMS) has updated the Appeals of Claims Decisions chapter of the Medicare Claims Processing Manual. The changes will be effective beginning July 23, 2013. The updates were enacted to ensure consistency with provisions of the Final Rule issued December 9, 2009, to improve and clarify operating instructions and language, and to reinstate sections that were removed during previous manual updates.

Changes include:
• Additional terms in the glossary;
• Supplementary examples such as detailed conditions and examples that may establish good cause for late filing by beneficiaries, providers, physicians, or other suppliers;
• Links to relevant forms.

To download a full copy of the updated manual, click here.

For more information about the CMS Manual, contact Jessica Gustafson, Esq. or Abby Pendleton, Esq. at (248) 996-8510.