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US · guidance

CMS Pub. 100-08, ch. 11, § 11.1.3.10

Postpay Complex Review Workload and Cost (Activity Code

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

21222)

(Rev. 89, Issued: 11-26-04, Effective: 12-27-04, Implementation: 12-27-04)

Contractors shall report all costs associated with Postpay Complex Review in Activity

Code 21222. In the workload section of Activity Code 21222, contractors shall report the

total number of claims reviewed on a postpayment basis as Workload 1 and report the

total number of claims denied in whole or in part as Workload 2. Report the number of

providers subject to postpay complex review in Workload 3. (IOM Pub 100-08, ch. 3.

§4.5.)

History

(Rev. 89, Issued: 11-26-04, Effective: 12-27-04, Implementation: 12-27-04)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
7658e8ecbbe4aa149c544f9202aad6494300e9bebfd2076c23ab14be037062c1
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