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User Enhancement Change Request (UECR): ViPS Medicare System (VMS) – Create an Audit Record for Manual Denials on Claim Edit Audit Trail (BUDS05

The purpose of this Change Request (CR) is to update BUDS05 to create an audit record when operators manually enter an Action Code on a claim line. This update will help in identifying when a claim was manually denied versus denied due to a SuperOp, EAR, VMAP table or other. It will assist the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) by reducing time spent on researching inquiries.

Download the Guidance Document

Final

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

Issue Date: February 23, 2023

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.