(AHA Coding Clinic,Fourth Quarter 2008 Page: 156-160) Provider's Role Documentation should demonstrate complete and concise picture of the patient's condition Treatment /Plan should link conditions to Organization Participant Guide". Centers for Medicare & Medicaid Services. Technical Guide Version 3.5, which was released in January of 2008, in advance of a future release of Technical Guide Version 3.6. This guidance does not constitute new policy, but rather highlights the opportunities available to use waiver supports to increase employment opportunities for individuals with disabilities within current policy. © 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in 3 of CMS's 2012 Regional Encounter Data Technical Assistance Participant Guide.2 A summary of the EDS filtering logic, as published in CMS's December 22, 2015, memo, is provided in Appendix A on page 5 of this paper. At first glance, it may seem that a burden has been lifted from MAOs because they no longer need to filter their claims Medicare Advantage Organizations Participant GuideVersion 3.1 A More Comprehensive Approach Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 4 The information presented in this course complies with accepted coding practices and guidelines as defined in the ICD -10-CM coding book. I think the most specific guidance from Medicare comes from the 2008 Participant Guide under Guidance for Problem Lists (7.2.4.3) "Although the term 'problem list' is commonly used with regard to ambulatory medical record documentation, a univeral definition does not exist. Medicare. Diagnoses from Telehealth Services for Risk Adjustment. 2021 Announcement. 2021 Advance Notice - Part II. 2021 Advance Notice - Part I. Announcements and Documents Archive. 2008-RAPS-Participant-Guide Download. Managed-Care-Manual-Chapter-7 Download. CMS 2020-Midyear_Final-ICD-10-CM-Mappings Download. The preceding description of Part B-covered services should be used only as a general guide, due to the wide range of services covered under Part B and the quite specific rules and regulations that apply. 2008. For outpatient mental health services, (see "Medicare Financing, Participant Premiums, 2003"), the per capita general revenue 2008 Risk Adjustment Data Technical Assistance For Medicare Advantage Organizations Participant Guide 6.4.1 Co-existing and Rel ated Conditions 24 3/14/2019 13 Guideline Specifics Language is Important: History vs Active "History of" is different for clinicians and coders 1. CMS-Centers for Medicare & Medicaid Services, "2008 Risk Adjustment Data Technical Assistance For Medicare Advantage Organizations Participant Guide." Leading Through Change, Inc. 2008 1-49. 2. The Joint Commission, Standards. The Joint Commission, 01 2012. CMS States "When reviewing medical records, pay special attention to the problem list on electronic medical records. Often, in certain systems, a diagnosis never drops off the list, even if the patient is no longer suffering from the condition. Conversely, the problem list may not document the HCC your MA contract submitted for payment." CMS States "When reviewing medical records, pay special attention to the problem list on electronic medical records. Often, in certain systems, a diagnosis never drops off the list, even if the patient is no longer s