US · guidance
CMS Pub. 100-06, ch. 6, § 460.7
Validation of Reports
The SSM shall automatically produce the CMS-2592 A/B MAC (B) appeals validation report and
the A/B MAC (B) performance validation report on a daily and monthly basis without specific
A/B MAC (B) maintenance or request or without A/B MAC (B) intervention.
Before sending the reports to CMS, check for completeness and arithmetical accuracy. Note
that the information provided below is applicable to each separate column. Use the following
checklist for an arithmetical check for each column:
• Line 1 equals Line 21 from previous month’s report.
• For each column, Line 1 plus Line 2 equals Line 3.
• Line 3 plus Line 4 minus Line 5 minus Line 6 minus line 12 equals Line 21 for each
column.
• Line 4.1 is equal to or greater than Line 4.a.
• Line 4.2.1 is equal to or greater than Line 4.2.
• The total of Line 6.1a through 6.1i equals Line 6.1.
• The total of Line 7.1a through 7.1i equals Line 7.1. (Not Applicable)
• The total of Line 8.1a through 8.1i equals Line 8.1.
• The total of Line 9.1a through 9.1i equals Line 9.1.
• The total of Line 10.1a through 10.1i equals Line 10.1.
• The total of Line 11.1a through 11.1i equals Line 11.1.
• Line 6.1 is equal to or greater than Line 6.
• Line 7.1 is equal to or greater than Line 7.
• Line 8.1 is equal to or greater than Line 8.
• Line 10.1 is equal to or greater than Line 10.
• Line 11.1 is equal to or greater than Line 11.
NOTE: For contractors handling MSP claims, totals for Lines 6.1 through 11.1 may or
may not be equal or greater to Lines 6 through 11, respectively.
• Line 8 plus Line 9 plus Line 10 plus Line 11 must equal Line 6.
• Line 8.2 plus Line 9.2 plus Line 10.2 plus Line 11.2 must equal Line 6.2.
• Line 15 plus Line 16 plus Line 18 plus Line 19 plus Line 20 equals Line 6.
• Line 15a plus Line 16a plus Line 18a plus Line 19a plus Line 20a equals Line 6.2.
• Line 22 plus Line 23 plus Line 24 plus Line 25 equals Line 21.
• Line 27 plus Line 28 plus Line 29 equals Line 26a.
• Line 30 equals Line 47 of the previous month’s report.
• Line 30 plus Line 31 equals Line 32.
• Line 33b must not exceed Line 33a.
• Line 33c must not exceed Line 33a.
• Line 33b plus 33c must equal Line 33a.
• Line 36 plus Line 36a plus 37 plus Line 37a equals Line 35.
• Line 41a is equal to or greater than Line 41.
• Line 42a is equal to or greater than Line 42.
• Line 43 plus Line 44 plus Line 45 equals Line 42a.
• Line 46a must not exceed Line 46 (Not Applicable)
• Line 48 plus Line 51 minus Line 52 equals Line 57.
• Line 48 equals Line 57 from the previous month’s report.
• Line 51a is equal to or greater than Line 51.
• Line 52a is equal to or greater than Line 52.
• Line 56a must not exceed Line 56. (Not Applicable)
• Line 53 plus Line 54 plus Line 55 equals Line 52a.
• Line 3 (Reopenings) plus Line 4 (Reopenings) equals Line 2 (Reopenings).
• Line 5 (Reopenings) must not exceed Line 2 (Reopenings).
• Line 5 (Reopenings) plus Line 6 (Reopenings) equals Line 2 (Reopenings)
• Line 6 (Reopenings) must not exceed Line 2 (Reopenings).
• Line 10 (Reopenings) plus Line 11 (Reopenings) plus Line 11a must not exceed Line 4
(Reopenings).
History
(Rev. 253, 08-06-15, Effective: 01-01-16, Implementation: 01-04-15)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
e4ff0bd535092d4817c5673cd6c5cfc977d527648d2827ebec2eb5b2d770867e
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