C2C's Top Three Appeals Categories

Published 04/22/2021

Did You Know?

The top three appeal categories, according to C2C Innovative Solutions, the Qualified Independent Contractor (QIC):

  1. LCD/NCD requirements not met
  2. MBPM requirements not met
  3. CFR requirements not met

The QIC found that of the following top three appeal categories, Imaging/Radiology had a 68.42 percent favorable rate, Drugs had a 45.90 percent favorable rate, Skilled Nursing Facility had a 35.14 percent favorable rate and the categories of Office E/M Services and Vision Services each had a 100 percent favorable rate after telephone discussions were held with C2C. More information about the PAE Demonstration telephone discussions can be found on the C2C Appeals-Demonstration webpage.

Pie chart of unfavorable decision by the QIC

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