Industry Notes: CMS: No Extensions on ADR Requests

Why This Topic Matters

The updates described can affect whether claims are paid, adjusted, returned, or held, and they also affect how providers respond to Medicare documentation and reporting requirements. Understanding the scope of these changes helps organizations maintain compliance and avoid preventable claim problems.

Article Sections

1. CMS: No Extensions on ADR Requests

   Covers a CMS update about response timing for additional documentation requests and the operational impact for providers and Medicare auditors.

2. Overlapping Claims Might Cause Unexpected Adjustments for Home Health

   Summarizes Medicare processing changes involving claim overlap checks and adjustments affecting home health billing in hospital and managed care situations.

3. HHAs: Get Manifestation Coding Right Or See Returned Claims

   Discusses a Medicare edit affecting home health claim submission and the need for proper diagnosis sequencing under ICD-9-CM guidance.

4. New CAHPS Exemption Form Available For Small Hospice Providers

   Describes a hospice survey participation exemption form and related reporting timing for small providers.