Medicare and medicaid documentation requirements

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U.S. Dept. of Health & Human Services

Complying With Medical Record Documentation Requirements Fact Sheet

Learn about proper medical record documentation requirments; how to provide accurate and supportive medical record documentation.

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: April 01, 2017

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.

Date Published: 5/27/2021