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October 5, 2015

SAVE TIME AND MONEY: Submit Reopenings via myCGS

myCGS, our free web portal for J15 providers, accepts provider requests for Reopenings! No postal fees and no postal delays, saves you time and money!

You may request Reopenings to correct minor errors and omissions without going through the formal appeals process. Reopenings may be requested within 12 months of the original claim remittance date to correct minor or clerical errors such as:

  • Mathematical or computational mistakes
  • Transposed procedure or diagnosis codes
  • Inaccurate data entry
  • Misapplication of a fee schedule
  • Computer errors
  • Correct dates of service (within the same year)
  • Adding or changing some modifiers

Please be advised, you may not request a Reopening if the change you are requesting will result in an overpayment; e.g., changing a procedure code to one that has a lower allowed amount than the code that was previously allowed and paid on the original claim.

Also, claims which are rejected as "unprocessable" (remark code MA130 etc.) are not eligible. Claims rejected as "unprocessable" must be corrected and resubmitted as new claims.

For more details on submitting requests for Reopenings, please refer to the Reopening vs. Redetermination Job AidPDF. To submit a request for Reopenings through myCGS, step-by-step instructions are available to assist you in the Part B provider section of Chapter 7PDF in the myCGS® user manual. You will also find details on how to track and check the status of Reopening requests submitted though myCGS®.

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