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View TPE round results for drugs and biologicals (HCPCS J7318-J7329, J7331-J7332).
This checklist is intended to provide healthcare providers with a reference for use when responding to medical documentation requests for therapeutic radiation services.
View this article for information concerning requirements of change request 13164.
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for aftercare, musculoskeletal system and connective tissue (DRG 559, 560 and 561) services.
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for cardiac defibrillator implant w/o cardiac cath (DRG 226 and 227) services.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for endovascular cardiac valve replacement and supplement procedure (DRG 266 and 267).
View targeted probe and educate (TPE) round results for wound care (CPT 11042 and 11045).
TPE is one process that a MAC can utilize when providers are selected by medical review.
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for major hip and knee joint replacement or reattachment of lower extremity (DRG 469 and 470) services.
Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically reasonable and necessary.