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".
Current versions of the Important Message from Medicare (IM), Form CMS-10065, 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.”
April 6, 2020: Hospitals are strongly encouraged to begin using the new Important Message from Medicare (IM) and Detailed Notice of Discharge (DND) as soon as possible, but no later than May 1, 2020.
January 7, 2020: The Office of Management and Budget (OMB) has renewed the IM (CMS-10065) and DND (CMS-10066). Please note the IM has been revised and has a new CMS Form number (CMS-10065), it was formerly the CMS-R-193.
The notices, including Spanish versions, are available below under “Downloads.”
Questions regarding the IM and DND can be submitted at: https://appeals.lmi.org