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System Changes to VMS to Allow DME MACs to Adjust Claims Denied as a Result of ZPIC Auto-Denial Edits to Pay After an Appeals Decision

CMS has determined that the VMS systems should allow the DME MAC to bypass auto deny edits set by the Zone Program Integrity Contractors (ZPICs) for a specific claim, rather than deactivating the auto denial edits at the risk of paying new claims.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: April 22, 2011

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.