Medicare Claims Processing Manual (Pub. 100-04), Ch. 30 § 150.5.2.1
Denial of Payment in Advance
150.5.2.1 - Denial of Payment in Advance
(Rev. 1587, Issued: 09-05-08, Effective: 03-03-08, Implementation: 03-01-09)
Denial of payment in advance under §1834(a)(15) of the Act refers both to cases in which
the supplier requested an advance determination and the contractor determined that the
item would not be covered, and to cases in which the supplier failed to request an
advance determination when such a request is mandatory.