Medicare Program Integrity Manual (Pub. 100-08), Ch. 11 § 11.1.3.8
Complex Probe Review Workload and Costs (Activity Code
11.1.3.8 - Complex Probe Review Workload and Costs (Activity Code
21220)
(Rev. 130, Issued: 11-10-05, Effective: 10-01-05, Implementation: 12-12-05)
Report all costs associated with complex probe review in Activity Code 21220. In the
workload section of CAFM II, Activity Code 21220, report the number of claims
reviewed in Workload 1. Report the number of claims denied in whole or in part in
Workload 2. Report the number of providers subject to complex probe review in
Workload 3.