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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.
View TPE round results for evaluation and management services - outpatient office visits.
This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for Mohs micrographic surgery services.
Summary for hyperbaric oxygen therapy (October 2020).
View this summary for outpatient rehabilitation services (August - November 2020 and August 2021).
Review this checklist to learn about the documentation requirements for medical professionals related to the repetitive, scheduled, non-emergency prior authorization program.
Review this checklist to learn about the documentation requirements to ensure an affirmed decision on your prior authorization request (PAR) for repetitive, scheduled, non-emergency transport.
Read this article to learn more about CERT reviews for vaccine and roster billed claims.
This checklist is an aid to assist providers with responding to medical record documentation requests.