Claim Chart Review Switch

SAS Name

This variable is used to indicate whether the encounter record is a chart review record. Chart reviews are a type of encounter data record that allow Medicare Advantage Organizations (MAOs) to add or remove diagnoses that they identified through medical record reviews that were not initially reported on encounter data records.


This is an indicator value that is set to ‘Y' when MAOs report diagnoses obtained from medical record reviews (i.e., chart reviews) that were not initially reported on encounter data records  when the MAO submitted the encounter. Otherwise, the value is set to null.

Chart review records may be submitted for any service type (including services that are not eligible for risk adjustment), and there are no limitations on the number of chart review records in totality or per encounter.   

Additional details regarding the meaning and use of chart review records can be found in the Medicare Encounter Data User Guide. 

Source: Medicare Advantage Organizations (MAOs) 

Code Code value
Y Record is a chart review
Null/missing Record is not a chart review