Detailed exam on everyone!

chriskhans

Networker
Local Chapter Officer
Messages
39
Best answers
0
My providers do at least a detailed exam on every patient that comes into our office no matter what they are being seen for. This is excessive, and I don't feel right counting skin and/or musculoskeletal for someone who is just coming in for an asthma checkup.
Is it appropriate for me to NOT count these because they aren't necessary?

Thanks!
 

mitchellde

True Blue
Messages
13,321
Location
Columbia, MO
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0
If the diagnosis does not support the exam and the provider does not provide any rational as to why certain things were examined then no it cannot be counted. CMS states that medical necessity is the overarching criteria for a visit level. While a detailed exam can be performed the question is SHOULD it have been performed given there sending problem.
 

mdzcpc-i

Networker
Messages
26
Location
Whittier, CA
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0
Medical Necessity

If the diagnosis does not support the exam and the provider does not provide any rational as to why certain things were examined then no it cannot be counted. CMS states that medical necessity is the overarching criteria for a visit level. While a detailed exam can be performed the question is SHOULD it have been performed given there sending problem.
Hi Debra,

Could you tell me where I can find on CMS website about the medical necessity?

I would appreciate much. :)

Mary Diaz, CPC, CPC-I
 
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