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Modification of Existing Common Working File (CWF) Editing for Preventive Services

The purpose of this Change Request (CR) is to modify existing Common Working File (CWF) editing for preventive services. In some instances, when claims are paid outside the CWF, the beneficiary’s claim history is not updated in the CWF, leading to incorrect claim's history. To avoid this and make CWF information more accurate, this CR allows frequency limitation editing to be overridden by contractors. In addition, this CR updates IOM Pub.100-04, Chapter 4, Section 300.5.

Download the Guidance Document

Final

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

Issue Date: July 21, 2022

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.