The Reopenings Modifier Adjustment Request Form

In the comings months, CGS will introduce a number of new forms to request specific types of Reopenings.  This process improvement will help facilitate their efforts to automate Reopenings, which will, in time, result in a more efficient process. The first in a series of new forms is the Medicare Part B Reopenings Modifier Adjustment Request Form.  This form will allow you to request simple corrections specific to adding, replacing, or deleting a modifier on a previously processed claim.  Only one claim can be corrected per form; up to 10 modifier corrections for a single claim. In order to use the new form, you must have access to your Remittance Advice (RA), as information from the RA must be entered into specific fields of the form.  To address legibility issues, we encourage you to complete the form online, and then print it.