Medical review

This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for nursing home services.

TPE is one process that a MAC can utilize when providers are selected by medical review.

View these current post-payment service-specific reviews and available results.

This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for chemotherapy, drugs, biologicals, and injection services.

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…

This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for critical care services.

This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for E/M services (on or after January 1, 2023, for office/…

Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically reasonable and necessary.

This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for skin substitutes. Health care providers retain the…

This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for endovascular cardiac valve replacement and supplement procedures (DRG 266…