Medicare Program Integrity Manual (Pub. 100-08), Ch. 11 § 11.1.3.10
Postpay Complex Review Workload and Cost (Activity Code
11.1.3.10 - Postpay Complex Review Workload and Cost (Activity Code
21222)
(Rev. 89, Issued: 11-26-04, Effective: 12-27-04, Implementation: 12-27-04)
Contractors shall report all costs associated with Postpay Complex Review in Activity
Code 21222. In the workload section of Activity Code 21222, contractors shall report the
total number of claims reviewed on a postpayment basis as Workload 1 and report the
total number of claims denied in whole or in part as Workload 2. Report the number of
providers subject to postpay complex review in Workload 3. (IOM Pub 100-08, ch. 3.
§4.5.)