Tuesday, May 12, 2015

CMS updates guidance for reopening claims beyond claim filing time frames

Dan Ciolek


The Centers for Medicare and Medicaid Services (CMS) recently updated the MLN Matters® Number: SE1426 article titled Scenarios and Coding Instructions for Submitting Requests to Reopen Claims that are Beyond the Claim Filing Time frames – Companion Information to MM8581: “Automation of the Request for Reopening Claims Process.” This article is intended to provide additional information, coding instructions and scenarios for requesting a reopening of a claim that is beyond the filing time frame. It is a companion article to MLN Matters® Article MM8581

 The effective date for the provisions described is for claims submitted on or after January 1, 2016. SNF billers should review this information.

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