epnorman
New
My company recently paid for a private auditor to come in and assist the providers with correctly documenting Routine Foot Care, Mycotic Nails, etc as this seemed to be a problem area for them in the past on previous audits.
The auditor came back stating that Medicare requires the medical note to show that "application of topical anti-fungal nail agent" was used. HOWEVER - I attended the McVey Podiatry Seminar in June 2017, have a copy of the 2017 Podiatry manual and NO WHERE in this book, or on the CMS website does it state that the medical note must show a topical anti-fungal agent was used. The material pulled for the manual is directly from CMS.
Per the auditor, this "application of topical anti-fungal nail agent" is something he has learned over the years through extensive face-to-face discussions with Medicare during court hearings. Per the auditor, it must be in the documentation.
My thought: if Medicare doesn't list it in their podiatry guidelines in plain black and white letters (just as we all have learned as coders "if it isn't in the medical document, it didn't happen") then how can Medicare possibly expect the providers to KNOW that this is supposed to be a documented course of treatment? I do not want to take the word of one privately paid auditor.
Has anyone else come across this in their audits?
The auditor came back stating that Medicare requires the medical note to show that "application of topical anti-fungal nail agent" was used. HOWEVER - I attended the McVey Podiatry Seminar in June 2017, have a copy of the 2017 Podiatry manual and NO WHERE in this book, or on the CMS website does it state that the medical note must show a topical anti-fungal agent was used. The material pulled for the manual is directly from CMS.
Per the auditor, this "application of topical anti-fungal nail agent" is something he has learned over the years through extensive face-to-face discussions with Medicare during court hearings. Per the auditor, it must be in the documentation.
My thought: if Medicare doesn't list it in their podiatry guidelines in plain black and white letters (just as we all have learned as coders "if it isn't in the medical document, it didn't happen") then how can Medicare possibly expect the providers to KNOW that this is supposed to be a documented course of treatment? I do not want to take the word of one privately paid auditor.
Has anyone else come across this in their audits?