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10.15.2019 Codes Found in Medical Records For General Guideline 31: Supplemental Data, does removal of the hybrid data elements requirement mean that codes found in the medical record may be used as proof of service even if there is no additional documentation of the service provided?

No. Codes alone (without additional documentation of the service provided) do not meet criteria for proof of service. If a provider performs a service, it is expected that additional documentation exists in the medical record or in the primary source document. Auditors must validate, through primary source verification, all elements required by the administrative measure specification.

ALL 2020