Are encounter data records and chart review records with default NPIs for atypical providers considered for risk calculation?


Answer:

Yes, risk adjustment filtering logic includes diagnoses captured from atypical provider service records (as indicated by the default atypical National Provider Identifier). All risk adjustment filtering logic and requirements remain in effect for atypical providers.

Source: MAO Help Desk Inquiry answered in November 2019


Last Updated: 11/01/2019