progression claim

[judyd]

I just sent out my progression claim, with my second echo, and I'm still waiting to hear about my 3rd Circuit Appeal of my original echo

[realmarie]

Judy, I hope you realize that unless the 3rd circuit reverses your show cause finding of mild mitral (a shot in the dark), you're going to end up being paid on the lower B matrix for a mitral progression claim - anyone who had an echo done within the scrrening period showing only mild mitral is stuck on the B matrix no matter what. And that's assuming you actually manage to get a mitral progression claim approved. It's not as easy as you might think. You have to meet strict criteria, point for point, or else they'll deny it. Read through some of the failed show cause higher level results to get an idea of how stringently they will adhere to the criteria. Good luck.

[judyd]

they are both progressing at the same time, and a shot in the dark is better than no shot , and either way I'm not done with them yet