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US · guidance

CMS Pub. 100-06, ch. 6, § 430.8

Completing Lines Twenty-Seven Through Thirty-Four - Denials

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

Appealed

(Rev. 6, 08-30-02)

B3-13430.8

Line 27 - Pending End of Last Quarter - The CROWD system will automatically enter the value

from line 34 on the previous quarter's report.

Line 28 - Adjustments - If it is necessary to revise the pending figure for the close of the previous

quarter because of inventories taken or reporting errors discovered, the carrier enters the

adjustment here. Adjustments can be positive or negative values. If entering a negative value, it

precedes the number with a minus (-) sign.

Line 29 - Adjusted Opening Pending - The CROWD system will automatically sum the values

on lines 27 and 28.

Line 30 - Appeals Received - The number of appeals of previously denied applications received

during the reporting quarter.

Line 31 - Denials Sustained - The number of appeals processed for which the carrier sustained the

initial denial.

Line 32 - Denials Overturned - The number of appeals processed for which the carrier

overturned the initial denial.

Line 33 - Total Appeals Processed - The CROWD system will automatically sum the values on

lines 31 and 32.

Line 34 - Pending End of Quarter - -The CROWD system will automatically compute the

number of appeals pending at the end of the reporting quarter by adding the value on line 29 to the

value on line 30 and then subtracting the value on line 33.

History

(Rev. 6, 08-30-02)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
9b44a80cdb29551d1cf3fc94306c44b51280455a484938d69e0443d125e6d039
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