Medicare Claims Processing Manual (Pub. 100-04), Ch. 34 § 10.6
Timeframes to Reopen Claim Determinations
10.6 - Timeframes to Reopen Claim Determinations
(Rev. 3568, Issued: 07-29-16, Effective: 09-30-16, Implementation: 09-30-16)
Our regulations establish timeframes that restrict the ability of the contractor to reopen
claim determinations. See 42 CFR 405.980(b) and (c) for the timeframes for reopenings.
The specific timeframes for contractor-initiated and party-requested reopenings are
detailed below.