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Medicare Program Integrity Manual - CMS

Medicare Program Integrity Manual - CMS

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CMS-Pub. 83 Chapter 6, Section 3.4.4, Claim Selection, instructs contractors to initially target MR on areas of PPS vulnerability, with a shift to data analysis as it becomes available. Chapter 6, Section 3.4.5, Record Request, specifies examples of medical record documentation that may be necessary to conduct MR.

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