Medicare Program Integrity Manual (Pub. 100-08), Ch. 11 § 11.1.3.2
Routine Review Workload and Cost (Activity Code 21002)
11.1.3.2 - Routine Review Workload and Cost (Activity Code 21002)
(Rev. 130, Issued: 11-10-05, Effective: 10-01-05, Implementation: 12-12-05)
Contractors shall report all costs associated with routine reviews in Activity Code 21002.
Costs associated with collecting an overpayment shall not be reported to this activity
code. In the workload section of CAFMII, Activity Code 21002, report the number of
claims reviewed in Workload 1. Contractors shall report number of claims denied in
whole or in part in Workload 2. Include those post payment claims where no
documentation was received in workload 2. Report the number of providers subject to
routine review in Workload 3. (IOM Pub 100-08, ch.3 §3.4.5.)