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Lowest documentation standard: Marketplace listings without manufacturer identification, lot numbers, COAs, or NDC

Payers typically reject non-specific codes like M54.50 (low back pain, unspecified) when the clinical record supports a more specific diagnosis

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Commenters stated that using Medicare data on fee-for-service case counts to develop a single weighted average standardized median MAO payer-specific negotiated rate by MS-DRG across hospitals means that data from hospitals with less MA penetration, which have less at stake in MA negotiations, is weighted more heavily than data from hospitals with high MA penetration that have more at stake