Medical Review (MR)

Documentation Requirements - View reference guides for submitting documentation to Medicare

How Do I Check DDE for an ADR? - Learn how to monitor ADRs through DDE

How Do I Respond to an ADR? - Learn about the ADR process and how to submit requested documentation

MR FAQs - View frequently asked MR related inquiries and the answers to them

MR Overview - View the MR primary mission, plan and philosophy

Medical Documentation Signature Requirements - View signature requirement details

Order Authentication Requirements - View requirements as a condition of participation

Reviews (Noridian) - View current and completed Noridian pre-payment service specific reviews

Targeted Probe and Educate (TPE) - View information on the TPE pilot process

Who Reviewed My Claim? - View information to help providers determine which contractor reviewed a claim

Why is My Claim Denied? - How to access narrative detail reasons on reviewed claims

Other Review Contractors - Multiple CMS contractors complete reviews of medical records. This includes Comprehensive Error Rate Testing (CERT) Contractor, Recovery Auditor (RA) Contractor, and many more. View details
 

Last Updated Jan 09, 2018

CPT and ADA End User License Agreement for Providers

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CPT codes, descriptors and other data only are copyright 2016 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.

Last Updated May 16, 2017