TMPPM 2010 > Volume 1, General Information > Section 7: Appeals > Appeal Methods > Electronic Appeal Submission > Disallowed Electronic Appeals

7.1.1.2 Disallowed Electronic Appeals

The following claims may not be appealed electronically:

•Claims that require supporting documentation (e.g., operative report, medical records, home health, hearing aid, and dental X-rays).

•Diagnosis-related group (DRG) assignment.

•Medicare crossovers.

•Claims listed as pending or in process with explanation of pending status (EOPS) messages.

•Claims denied as past filing deadline except when retroactive eligibility deadlines apply.

•Claims denied as past the payment deadline.

Exception: Inpatient hospital claims denied for lack of a Hysterectomy Acknowledgment Statement or a Sterilization Consent Form may be appealed electronically if the requested form has been faxed according to the instructions in Form GN.9, "Hysterectomy Acknowledgement Form" in Gynecological and Reproductive Health, Obstetrics, and Family Planning Services Handbook (Vol. 2, Provider Handbooks).