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    • Latest updates: Enrollment (6)
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    • Appeals (4)

    Update of the 2025 dollar amount in controversy required to sustain appeal rights for an Administrative Law Judge (ALJ) Hearing or Federal District Court Review

    Section 1869(b)(1)(E) of the Social Security Act (the Act), as amended by Section 940 of the Medicare Prescription Drug...

    • Latest updates: Appeals
    • December 16, 2024

    Tutorial: Completing the Medicare Part A redetermination and clerical error reopening request form

    Review our tutorial and learn how to correctly complete this form to ensure more accurate processing.

    • Latest updates: Appeals
    • September 7, 2025

    Claims and appeals for CPT 93010 performed in emergency room setting

    Please review this article regarding appeals received for CPT 93010 (electrocardiogram report) and the use of modifier 77.

    • Latest updates: Appeals
    • July 13, 2025

    Positron emission tomography (PET) for oncologic conditions: Modifier usage

    The appeals department is receiving appeals regarding the incorrect usage of modifiers associated with PET scans. Read this...

    • Latest updates: Appeals
    • July 13, 2025
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