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Wiki Question re: ROS

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Cyndi113

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I'm attempting to get a complete ROS. However, my MD is not cooperating. This patient is post grand mal seizure and post-extubation before my MD completed a consult. His ROS is as follows: He and young lady at bedside deny any other serious illnesses. Ten-system review is unremarkable.

My inclination is not to give him credit for a complete ROS. I'm trying to get him to be more consistent with his ROS. Am I being to strict with him? He did a lot of work with this patient and I really want to give him credit for the consult.

HELP, please...? Thanks so much,
 
There are 14 systems

There are 14 systems ... saying "ten system review unremarkable" doesn't get ANY ROS points in my book because I have no idea WHICH 10 systems are reviewed.

He should list pertinent positives and negatives, and (depending on the state you are in and whether this is a Medicare/Medicaid patiient) "all other systems reviewed and negative" if he wants to get full credit for a complete ROS.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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