TMPPM 2008 > Provider Information > Appeals > Appeal Methods

6.1.4.1 Fee-for-Service DRG Adjustment Appeal

Fee-for-service hospital providers that are appealing for a DRG adjustment (higher weight DRG) must provide the original and revised UB-04 CMS-1450, the complete medical record, and a statement defining the reason for the requested change. Hospitals have 120 days from the date of the R&S report to request an addition of a diagnosis or procedure resulting in a DRG adjustment.

Refer to: "Utilization Review Appeals" .