Hi
I am dr sunil from mumbai
you can take one bullet for constitutional area for ROS "Overall she is feeling well"
dr Sunil
Mumbai India
Hello, Dr. Sunil!
Let me put it this way: I wouldn't allow credit for that statement in an audit, because it's too vague, and doesn't pertain to any one particular system. There's simply too much room for interpretation.
On the other hand, if I were having to
defend this to an auditor, I'd probably argue that it
could fall under Constitutional, as you've suggested. The difference is in the perspective: Auditors should strive to educate the physician on acceptable documentation techniques; we're not doing anybody any favors by being liberal with the credit we're assigning. Since coding and auditing are
so subjective, the best way to ensure compliance, is to prepare for the worst case scenario.
Practice administrators and appeals specialists have a different interest, though - they are concerned with the bottom line. Appeals specialists should try to fiercely defend their providers' code choices to the best of their abilities, and sometimes that means employing creative interpretation of the guidelines, when necessary.
Auditors keep it black and white, and appeals specialists are all about shades of grey. I hope that was helpful, and not confusing!
Have a great day!