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US · guidance

CMS Pub. 100-04, ch. 24, § 50.10.2

PWK Workflow

activein force · 2026-08-25 – presentas-observed

The PWK segment is the “electronic staple” which connects paper documentation to an

electronic claim. Claims are submitted electronically with the PWK segment populated.

The additional documentation is then submitted to the A/B MACs, DME MACs or CEDI

at the same time or within close proximity of the electronic claim. If needed, the A/B

MACs, DME MACs or CEDI will use the additional documentation in their adjudication

of the claim. If the claim does not require additional documentation, the claim will be

adjudicated without reviewing the additional documentation. If the additional

documentation is not received or provides no value, the claim will be handled as it

normally would have if the PWK data not been submitted.

History

(Rev. 2803, Issued: 10-28-13, Effective: 09-17-13, Implementation: 09-17-13)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
c3affb051e6a499ed83b69a8ec50801447dd2aab65dcf2018573dc8a17498b55
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