These checklists are intended to provide healthcare providers with a reference for use when responding to CERT documentation requests for the selected claim sample. It is not intended to replace any guidelines from CMS. Healthcare providers retain responsibility to submit complete and accurate documentation upon request to Medicare. Checklists covering additional topics are available on the CERT C3HUB website under the Documentation Request Listings link.
Topic
Checklist
Aftercare, Musculoskeletal System & Connective Tissue (DRG 559, 560 and 561)
Documentation checklist
Cardiac Defibrillator Implant W/O Cardiac Cath (DRG 226 and 227)
End stage renal disease (ESRD) documentation
Endovascular Cardiac Valve Replacement and Supplement Procedures (DRG 266 and 267)
Hospital inpatient (Part A)
Hospital outpatient
Major Hip And Knee Joint Replacement or Reattachment of Lower Extremity (DRG 469 and 470)
Other Musculoskeletal System and Connective Tissue OR Procedures (DRG 515, 516 and 517)
Percutaneous Intracardiac Procedures (DRG 273 and 274)
Skilled nursing facility (SNF) inpatient
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