How can MAOs and other entities delete diagnosis codes from the Encounter Data System (EDS)?


MAOs and other entities can delete diagnoses from encounter data records by submitting void, replacement, or chart review delete records. A void record will delete all diagnoses on the encounter or chart review record that it is linked to; a replacement record will delete any diagnosis code on the original record, but not on the replacement record; and a chart review delete will delete diagnosis codes that are listed on the chart review delete record from the record that the chart review delete is linked to.
Voids and replacements must be submitted as the same type of record as they are trying to replace or void. For example, if a chart review record is being replaced, the replacement record must also be indicated as a chart review. However, a chart review delete may be linked to either an encounter or chart review record.
In all cases a record that is deleting diagnoses must be linked. An unlinked chart review record does not reference the Internal Control Number (ICN) of a previously submitted and accepted record. Because the ICN is not referenced, CMS cannot determine which record the unlinked chart review record would be deleting from. Unlinked chart review records attempting to delete diagnoses will be rejected with edit code 00805 – “Deleted Diagnosis Code Not Allowed.” Furthermore, a diagnosis delete record deletes only the diagnoses from the record it is linked to, and not from other records. In other words, for each instance of a diagnosis to be deleted, MAOs or other entities must submit a separate Linked Chart Review Record (CRR) Delete. Additional information is available in Encounter Data Submission and Processing Guide, Chapter 2.3.

Source: User Group Q&A Documentation from April 27, 2017

Last Updated: 04/27/2017