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welcome to this DME on demand for prior authorization billing modifiers and Medicare secondary payer MSP the purpose of this training is to provide billing information as it pertains to this required prior authorization program the information given in this training is correct as of today the most current information related to this topic can be found on the nerian Medicare website and the CMS website at the links listed on this slide if submitting a prior authorization claim with either an affirmed or a nonaffirming must contain the 14 byte unique tracking number or utn that is located on the decision letter the utn should be listed in item 23 of the paper claim or Loop 2300 or 2400 of the electronic claim if the supplier has submitted a prior authorization request or par to the durable medical equipment Medicare administrative contractor DME Mac and the decision is provisionally affirmative or to allow and the supplier chooses to deliver the item and submit a claim the DME Mac will p