A Medicare Administrative Contractor issues an Additional Documentation Request (ADR) for an office-billed service. What is the appropriate response?
Select an answer to reveal the explanation.
Short Explanation
An ADR is a homework assignment with a due date—send the real chart, signed and complete, that backs the service you billed. Superbill scraps or silence will not satisfy medical review. Answer on time with the authenticated notes, not a quiet CPT downgrade to dodge the request.
Full Explanation
ADRs require timely submission of documentation sufficient to support medical necessity and coding of the billed professional services. Responses should include complete, authenticated clinical records rather than charge tickets alone. Ignoring the request, providing inadequate documents, or merely rebilling a different code without responding risks denial and compliance exposure.