Medical documentation
Checklist: Critical care
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for critical care services.
Checklist: Evaluation and management (E/M) services documentation
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/…
Checklist: Application of skin substitutes
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…
Checklist: Cardiac defibrillator implant w/o cardiac cath
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.
Checklist: Major hip and knee joint replacement or reattachment of lower extremity
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 (…
Checklist: Nursing home
This checklist is being provided as a tool to assist providers when responding to medical record documentation requests for nursing home services.
Checklist: Inpatient admission documentation
This checklist is an aid to assist providers with responding to medical record documentation requests.
Checklist: Clinical labs
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests pertaining to clinical lab drug testing. Health care providers…
Checklist: Chronic care
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for chronic care management (CCM) services.
Checklist: Outpatient therapy and rehabilitation services
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for therapy and rehabilitation services.