Tiptastic Tuesday: New Timeframe For Response To Additional Documentation Requests

CMS had revised its instructions as they related to Change Request (CR) 8583, which instructs MACs and Zone Program Integrity Contractors (ZPICs) to produce pre-payment review Additional Documentation Requests (ADRs) that state that providers and suppliers have 45 days to respond to an ADR issued by a MAC or ZPIC. Failure to respond within 45 days of pre-payment review ADR will result in denial of the claim(s) related to the ADR. Please make sure your billing staff is aware of these changes.

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