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Is it appropriate to use “alternate” or “spare” records in the Claims Review?

April 26, 2017alternate appropriate records review spare

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Is it appropriate to use “alternate” or “spare” records in the Claims Review?

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Generally, the use of alternates or spares is not permissible for CIA Claims Reviews, as stipulated in current CIAs. If a record or supporting documentation cannot be located, the reviewer should consider this item (e.g., claim, line item, encounter) to be an error/overpayment.