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Additional Documentation: Ways to Reduce Your Burden
You currently have jurisdiction selected, however this page only applies to these jurisdiction(s): .
WPS Government Health Administrators may not be able to process your claim without more information. The following are the most common situations where we need more documentation:
- Not Otherwise Classified (NOC) Codes – also utilize the narrative field (Item 19). Submit an operative report or other documentation that describes the service rendered. For drugs, this would include the drug name and dosage, and a possible invoice. Include a detailed note describing testing or other services. For more information on NOC codes see our resource: Billing and Describing NOC Codes.
- National Provider Identifier (NPI) information mismatch
- Multiple Units of the same service on the same day – Use the narrative field (Item 19).
- Find more information in: Correct Submission of Multiple Evaluation and Management (E/M) Services on a Single Day
- For radiology services, see Modifier 76 Fact Sheet and Modifier 77 Fact Sheet.
- You can access information on submitting multiple clinical lab services in Modifier 91 Fact Sheet.
- Modifier 22 – Unusual Services – This requires an operative report. This also requires a separate concise statement about how the service differs from the unusual. See the Modifier 22 Fact Sheet.
- Modifier 52 – Reduced Services
- Modifier 53 – Discontinued Services
- Modifier 62 – Co-surgery
- Modifier 66 – Team Surgeons
- Modifier 80, 81, 82, or AS – Assistant at Surgery
- When “0” payment indicator is in Column U of Physician Fee Schedule Relative Value Files.
With one exception, you can use the PWK segment of your electronic claim to alert us you have more documentation. It is the NPI mismatch that follows. You can submit additional documentation electronically at time of claim submission. This leads to faster processing of your claim. It allows you to bypass the time to get the Additional Documentation Request (ADR) letter to your office. It reduces your burden when the person submitting the claim knows the information necessary. The person can submit it at or near the same time as the claim. Correct use of the PWK segment saves your office money in copying, mailing, and/or faxing costs.
There may be situations where you are not aware of a need to submit more documentation prior to sending the claim. Use the PWK segment if we alert your office that all or certain claims will require documentation. This will reduce your burden.
What is PWK?
PWK (Paperwork) is a segment within the 837 Professional and Institutional electronic transactions. The PWK segment provides a “linkage” between electronic claims and additional documentation needed for claims adjudication. When you know we will need more documentation, use the PWK segment at the claim level (Loop 2300/2400). This allows the provider to submit electronic documentation. Through a dedicated PWK process, Medicare images, connects, and has this available during claim adjudication.
Information in the PWK segment does not require us to suspend processing the claim. If the claim suspends for more documentation, we will look for the PWK segment and the additional information submitted. If there is no required suspense, the claim will simply continue processing. Do not submit documentation without a request if your claim is not one of the situations listed above. If you find Medicare requests documentation on a particular claim type, then use the PWK segment for future claims.
Electronic Claim Requirements for PWK Segment
Create the 837 claim according to instructions in the Type 3 Technical Report (TR3) and the Companion document.
In Loop 2300 (Claim Information), PWK segment, (Claim Supplemental Information) use the following data elements to identify that a paper attachment is forthcoming.
PWK01 (Attachment Report Type Code) – Use the values indicated in TR3 to identify the type of attachment.
PWK02 (Attachment Transmission Code) – Indicates a code identifying how you will send the attachment. PWK02 – BM (by mail) FX (by fax)
PWK05 (Identification Code Qualifier) – Required when PWK02 = BM or FX
PWK06 (Attachment Control Number) – A value assigned by the provider to uniquely identify the attachment.
Additional Documentation Cover Sheet
Use the PWK Fax/Mail/esMD Cover Sheet to submit the unsolicited additional documentation. You can find this form on our Medicare Forms page. We require ALL fields on the cover sheet. Medicare does NOT allow ANY modifications to this cover sheet. We will return PWK cover sheets with missing or inaccurate information. We cannot use the documentation for claims processing and we cannot return it.
Documentation Submission Timeframe
Do not submit the documentation prior to submitting the claim. We will allow 7 calendar “waiting days” (from claim receipt date) for you to send the needed documentation. This applies to records sent by fax or electronically. We will allow 10 calendar “waiting days” for mailed documentation. We will not hold claims that would not otherwise suspend for additional documentation.
Follow the required steps to allow for correct processing.
- Submit the claim with the correct PWK indicator.
- Complete the WPS GHA Fax/Mail/esMD Cover Sheet.
- Include one cover sheet per claim submitted.
- Complete all blanks on the form.
- Submit the cover sheet with the documentation via fax, or by mail.
- Submit the documentation consistent with the method indicated in the PWK segment.
- Submit the documentation immediately following the claim submission. This will avoid delayed claim review and processing delays. We will not consider documentation received beyond the “waiting days” time limit.
NOTE: If we send an ADR letter for a claim, DO NOT respond through the PWK process. This will delay the processing of your claims.
No PWK, but ADR letter
If there is no PWK, but we need additional documentation, we will send an ADR letter. This letter is specific to the claim in question. Providers must return the letter along with the documentation and/or information requested.
When returning the documentation, use the appropriate Development Resolution form for your state.
You have 45 days from the date of the ADR to respond. When responding to more than one ADR, separate any documentation for the different claims by the ADR letters.
Tips to expedite receipt of the documentation
- Obtain the claim Internal Control Number (ICN) for the pending claim from the WPS Government Health Administrators Portal.
- Enter the ICN in the appropriate field on the Development Resolution Form.
- Send the completed form along with the documentation to the correct Fax Number.
- Complete one form for each claim control number.
- Do not send the WPS Government Health Administrators Portal screen print with the faxed documents.
If we didn’t receive documentation timely, use the PWK segment and send a new claim. If your claim has appeal rights, you may request an appeal.
No PWK, but ADR letter
If there is no PWK, but we need additional documentation, we will send an ADR letter. This letter is specific to the claim in question. Providers must return the letter along with the documentation and/or information requested.
When returning the documentation, use the appropriate Development Resolution form for your state.
You have 45 days from the date of the ADR to respond. When responding to more than one ADR, separate any documentation for the different claims by the ADR letters.
Tips to expedite receipt of the documentation
- Obtain the claim Internal Control Number (ICN) for the pending claim from the WPS Government Health Administrators Portal.
- Enter the ICN in the appropriate field on the Development Resolution Form.
- Send the completed form along with the documentation to the correct Fax Number.
- Complete one form for each claim control number.
- Do not send the WPS Government Health Administrators Portal screen print with the faxed documents.
If we didn’t receive documentation timely, use the PWK segment and send a new claim. If your claim has appeal rights, you may request an appeal.
global-tags: Documentation Submission,J8A,J5A,J8B,J5B,Claims
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