Revision of PWK (Paperwork) Fax/Mail Cover Sheets
Change Request (CR) 10124 alerts providers that their MAC will provide revised fax/mail cover
sheets via hardcopy and/or electronic download. These revised documents are attached to
CR10124. There are three paperwork (PWK) attachments to CR10124: (1) Medicare Part A
Fax/Mail Cover Sheet (2) Medicare Part B Fax/Mail Cover Sheet and (3) Medicare DME MAC
Fax/Mail Cover Sheet.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: November 09, 2017
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.