NKDA - How are others counting?

KurtRego

New
Messages
3
Best answers
0
I would be interested in finding out how fellow coders are currently counting the NKDA? Is this a ROS or counted as a PFSH?

Any input would be appreciated along with the rationale for the choice.

Kurt Rego, CPC
Corporate Compliance
 

rthames052006

True Blue
Local Chapter Officer
Messages
1,905
Location
York, Pa
Best answers
0
I was told at a Medicare seminar by the nurse reviewers that NKDA should be counted under PFSH. What do others do.

roxanne
 

coder911

Guest
Messages
54
Location
Portland
Best answers
0
I generally count this as an element of the ROS. If you look under medicare E/M guidelines it shows "allergic/immunologic" as a system - I perceive this as a general statement that can apply to any allergy reviewed. Allergies (unless otherwise stated) are a current issue for the patient - and can potentially affect the doc's treatment options.
 

kevbshields

Guest
Messages
1,101
Location
Louisville, KY
Best answers
0
CMS has made documentation guidelines for this relatively clear--where I (personally) find dissent is in the interpretation of presenters, auditors and educators.

According to CMS, it may be counted as either Past Med. Hx. or as a ROS (All/Imm), but only one of those. It is pretty standard for auditors/coders to just automatically slam it into PFSH, although it may be needed elsewhere (e.g., ROS). Since the allowance is permitted by CMS, I would say it needs to be counted where it is needed in the document.

If specific FIs have rules outside those of CMS, they should place those in writing. I would also pay heed to what the Medical Reviewers (not Clinical Reviewers) are stating from those FIs; these are the people reviewing your documentation, after all.

Hope this helps.
 
Messages
155
Location
Albany, NY
Best answers
0
Ros

I, personally, consider NKDA a ROS (allergy). Typically, past history is easy to get anywhere else and it's another point in the provider's favor to use it as a system.
 

donsqueen

Guest
Messages
113
Best answers
0
NKDA stands for no known DRUG allergies. My outside consultant said that it should be counted as PFSH over ROS for 2 reasons: 1: it is documented (in my clinic) by the MA's not the provider and 2: it is not generally specific to the particular problem the patient is coming in for.
 

goldejoa

Guest
Messages
28
Best answers
0
I always count it in ROS. In the ED, where I code, I feel it is always pertinent to nature of the presenting problem.

JG
 

khaspert

Contributor
Messages
14
Location
Cactus Wren
Best answers
0
Nkda

This is part of the past medical history.

If a patient is asked about other allergies such as environmental allergies like hay fever, this would be part of the ROS.
 

rthames052006

True Blue
Local Chapter Officer
Messages
1,905
Location
York, Pa
Best answers
0
This is part of the past medical history.

If a patient is asked about other allergies such as environmental allergies like hay fever, this would be part of the ROS.
I agree with you Khaspert... thats what I was taught by the auditors at Medicare.

Roxanne Thames, CPC
 
Top