The Centers for Medicare & Medicaid Services (CMS) issued Transmittal R554PI on November 14 to permit providers to request an extension of 15 calendar days to comply with additional documentation requests (ADRs). The change will be effective April 1, 2015.
The article is based on Change Request (CR) 8583, which instructs Durable Medical Equipment Medicare Administrative Contractors (DME MACs) and Zone Program Integrity Contractors (ZPICs) to produce ADRs that state that providers and suppliers have 45 days to respond to the ADR. ADRs will be revised to include that providers and suppliers can request the extension, if needed, to comply with the request. “The reviewer shall grant at least one extension for a period of 15 calendar days…,” according to the transmittal. If no documentation or request for extension is received, reviewers will deny claims for which the requested documentation is not received by day 46.
