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Part B Insider (Multispecialty) Coding Alert


Good News: You Now Have Better Appeal Chances for Certain Denied Claims

But make sure you pay attention to the many limitations on the new guidance. In a refreshing move from CMS, newly released guidance limits the scope of review for some redeterminations and reconsiderations. Now you’ll have a greater chance of winning appeals on Medicare claims denials. Scenario: Medicare paid your claim, but a Zone Program Integrity Contractor (ZPIC), Recovery Audit [...]