Hospital Discharge Appeal Notices
Full instructions for the Original Medicare, also known as Fee for Service (FFS), process are available in Section 200, of Chapter 30 of the Medicare Claims Processing Manual, available below in "Downloads".
To download the IM and DND and their instructions, please click on the appropriate link below in "Downloads".
Current versions of the Important Message from Medicare (IM), Form CMS-R-193, and the Detailed Notice of Discharge (DND), Form CMS-10066, are posted below under "Downloads".
Full instructions for Medicare health plans are available in Section 100 of the Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance, available below in “Downloads.”
October 30, 2019: The currently available Detailed Notice of Discharge (hospital notice) has an expiration date of October 31, 2019. This notice is now going through the Paperwork Reduction Act clearance process. The currently available hospital notice is covered under an extension and hospitals should continue using the current notice until CMS publishes the updated notice. Hospitals following this direction are fully compliant with our requirements.
Questions regarding the IM and DND can be submitted at: https://appeals.lmi.org