TN 13 (11-11)

A. Procedure for listings, diaries, and notices

Input or manually prepare all necessary listings, diaries and notices for claims processed in the field office (FO).

1. Listings

Add listing codes to claims involving certain types of issues according to pre-assigned numbers so that they can be controlled and resolved. Listing codes consist of three digits. For instructions on how to enter listing codes via the Modernized Claims System (MCS) decision (DECI) screen, see MSOM MCS 009.004. For instructions in establishing listings via the Processing Center Action Control System (PCACS) in manually processed cases, see MSOM PCACS 001.001.

Listings input via the MCS DECI screen will interface with PCACS and automatically establish the listing.

Annotate the report of contact (RPOC) screen with the applicable justification and listing code.

2. Diaries

Establish an appropriate FO control and a separate processing center (PC) diary when you adjudicate a claim but some issue(s) requires further development (e.g., partial adjudication). For diary codes and information, see GN 01040.010.

• Use internal controls (e.g., Modernized Development Worksheet (MDW)) to establish and follow up on FO controls.

• Use the MCS DECI screen to establish PC diaries whenever possible. MCS diaries will interface with the PCACS, establish a diary and generate the subsequent follow up alert in the PC.

• Annotate the RPOC screen with the related diary evidence Code(s) and a detailed rationale for the issue(s) under development.

• If you process the claim manually, the PC must establish the diary or listing manually in the PC. Annotate the diary request on the Benefit Continuity Remarks/Notice (BCRN) screen in the Automated 101 (A101) or the Electronic Form (EF101).

• Use a paper report of contact (RC) only if no RPOC screen or other appropriate electronic screen is available.

NOTE: Due to the number of technical issues possible for each diary evidence code, procedural description is necessary, see references in GN 01010.260.

Situations also exist when the interface system between MCS and PCACS does not detect the information or the evidence code is not included. Diaries without proper clarification from the adjudicator initiating the development, results in improper subsequent follow up and may not be clear. You must always annotate the RPOC screen in detail, with the exact reason(s) for development and the corresponding diary code(s). In addition, for medical re-examinations, pending WC/PDB development and deferred auxiliary claimant diaries on DIB claims, see DI 11010.030.

For instructions regarding diaries for end-stage renal disease (ESRD) Medicare claimants who received successful transplants, see HI 00820.030.

3. Notices

The FO is responsible for ensuring that the claimant receives proper notice of the determination in District Office Final Authorization (DOFA) claims. This includes:

• Ensuring the proper notice is designated with appropriate universal text indicator (UTI) paragraphs (e.g., MCS notice 2 (NOT2)/NOT3 screens) when the applicable processing system does not produce a completely automated notice; or

• Preparing special dictated language when necessary (e.g., via NOT2/ NOT3 screens, RPOC).

B. References

• GN 01040.100 Listing Codes

• MSOM MCS 009.004 Claims Clearance Menu (CMEN)

• MSOM PCACS 001.001 Processing Center Action Control System – Overview

• NL 00725.001 General - MCS Notices