We believe that providers have up to 18 months from the date of service for the initial submission, and no time limit on adjustment claims, including those for missing C codes, other than the statute of limitations, which is about seven years. There is, however, a practical time limit, in that you must usually perform an online adjustment to a claim within a couple of years of the initial submission. For example, this would be up to 42 months from the date of service, then an additional 24 months from the date of initial submission. The time frame for adjusting claims online depends on the fiscal intermediary (FI) system. In the FI standard system, claims may be “resurrected” to online status following FI instructions.
