What is issued when the MAC conducts a medical review and requests additional documentation?

The correct answer is the Advance Determination Request (ADR). When the Medicare Administrative Contractor (MAC) conducts a medical review, they often need further information to validate the claims submitted. In such situations, the MAC issues an ADR to request additional documentation from the provider. This detailed request specifies the information and records needed to assess the medical necessity and appropriateness of the services billed. The provider is expected to respond to the ADR within a certain timeframe to avoid potential claim denials.

The other options pertain to different processes in the billing and claims adjudication cycle. A Claim Denial Notice is issued when a claim is formally denied, while a Documentation Request may be more generic and not specifically tied to the ADR process. A Claim Adjustment Request, on the other hand, is used when there are changes needed to be made after a claim has been processed or paid. Thus, the ADR serves a specific role in ensuring that claims are thoroughly reviewed with the appropriate supporting documentation.