How does the MAO-004 report include diagnosis codes from both the original and replacement EDRs that are risk eligible?


For the diagnoses reported only on the replacement but not on the original, the MAO-004 will indicate these records as “Add” in the add/delete indicator. All diagnoses reported on both the replacement and the original encounter data record will be reported with a “blank” for the add/delete indicator, signifying that those diagnoses have been reported as “add” before, and all diagnoses on the original encounter data record, but not on the replacement record, will be noted as “Delete” in the add/delete indicator.

Source: CMS HPMS Memo with subject “Phase III Version 3 MAO-004 Report Release Date and Announcement Regarding Final Encounter Data Deadlines for Payment Years 2016-17” (December 20, 2017)

Last Updated: 12/20/2017