Create a New Adjustment Reason Code for Adjustments Created When the Provider Didn't Respond to an Additional Documentation Request (ADR)
The purpose of this Change Request (CR) is to create a new Health Insurance General Ledger Accounting System (HIGLAS) adjustment code to be applied when a payment is recouped because the provider didn't respond to a post-payment ADR. The new adjustment code will trigger specific language on the HIGLAS demand letter to explain the reason for the recoupment.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 24, 2025
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