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WorksheetsReopenings and Redeterminations
Total questions: 10
Worksheet time: 5mins
A reopening is a reprocessing of a claim to fix minor mistakes.
True
False
You will have as long as you want to submit a Redetermination.
True
False, you have 120 days from the claim determination.
A redetermination is an examination of a claim that includes analysis of documentation.
True
False
Modifiers 24, 25, 57, 58, 59, and 78 are some examples of Reopenings.
True
False
Modifiers 22, 52, 53 require claim documentation to avoid having to submit a redetermination.
True
False
When Medicare records are updated to show as primary payer, providers cannot reopen via Connex.
True
False
Are changing diagnosis codes redeterminations?
Yes
No
Would you reopen a claim to void line billed in error and resubmit a corrected claim?
No, correct the initial claim.
Yes
Are Modifiers GV and GW reopenings or redetermination
Reopenings
Redeterminations
When submitting a redetermination for repeat procedures, will you need to supply documentation on how many services were performed?
Yes
No
