Medical record reviews conducted by Independence’s Corporate and 
Financial Investigations Department (CFID) have shown that providers are 
billing higher levels of evaluation and management services based upon cloned 
documentation rather than the actual service provided. Cloned notes affect the 
integrity of the medical record.
What is cloning?
Cloning is when identical or similar documentation is used in a note 
describing an encounter. Medical records must contain documentation showing 
specific differences for each visit according to the needs of the patient for 
that date of service. Electronic medical records (EMR) enable quick access to 
patient records for more coordinated, efficient care. However, all forms of 
identical or similar documentation that are defined as cloning are a result of 
certain EMR features like:
- copy and paste
- auto-fill and auto-prompts (overdocumentation)
- pulling forward
- macros and/or templates
Medical records reflecting these patterns misrepresent the medical necessity 
required for reimbursement of services rendered and cause the accuracy of the 
documentation to be questioned.
Services that show evidence of cloning will not be considered for 
reimbursement because it is not possible to determine exactly how much work was 
performed during an encounter. Audit summaries that identify documentation 
associated with any form of cloning may result in recovery of overpayments.
Learn more
If you have questions about the content of this article, please email our 
Provider Communications team at provider_communications@ibx.com.