Wiki Medical necessity for hydration

[deanna104]

We are trying to get our providers to document more supporting signs and/or symptoms to support the medical necessity for the administration of hydration. Are your providers coming out and stating the reason the hydration was ordered? Are they doing this in their narrative or do you have it as part of your order entry?


While we would love our ED doctors to state the patient the patient is dehydrated and or cannot take anything by mouth as well as document other signs and symptoms it often is not done. If anyone has educated providers on this and is willing to share how you did that or the document they provided, that would be appreciated.

Thanks.

 

[thomas7331]

The facilities where I've worked, as far as I know, have never undertaken this. While I've noted that providers usually do not document the specific reason ordering hydration, I've never encountered an audit or payer policy that ever questioned this or denied hydration services for a lack of a particular diagnosis. Can I asked what has prompted your organization to feel the need to do this - have you had a problem with a payer? While hydration can be a treatment directed at a particular condition, more often than not it is a supportive measure used in conjunction with treatments for a wide variety of problems. I just can't imagine that a payer or auditor would want to target hydration coding for medical necessity issues or for lack of documentation. Wherever I've worked, there are usually so many other more important and pressing documentation issues that would take priority over something like this.