ejlight
Guest
When doctor dictates the review of systems what is the correct verbage for compliance when all systems were reviewed.
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Wiki review of systems
- Thread starter ejlight
- Start date
Pathos
True Blue
CMS says:
"A complete ROS inquires about the system(s) directly related to the problem(s) identified in the HPI plus all additional (minimum of ten) organ systems. You must individually document those systems with positive or pertinent negative responses. For the remaining systems, a notation indicating all other systems are negative is permissible. In the absence of such a notation, you must individually document at least ten systems".
Your provider should still itemize each positive ROS that was reviewed with pertinent details. As for the negatives, there is some confusion when I read old forum posts, however the statement from CMS above suggests that we can use a phrase to "indicate all other systems are negative". Perhaps after stating all positives:" All other Review of Systems have been reviewed and are negative" or something along those lines.
You may still want to check with your carrier/payer, as some commercial payers might not accept such verbiage.
Hope this is helpful.
"A complete ROS inquires about the system(s) directly related to the problem(s) identified in the HPI plus all additional (minimum of ten) organ systems. You must individually document those systems with positive or pertinent negative responses. For the remaining systems, a notation indicating all other systems are negative is permissible. In the absence of such a notation, you must individually document at least ten systems".
Your provider should still itemize each positive ROS that was reviewed with pertinent details. As for the negatives, there is some confusion when I read old forum posts, however the statement from CMS above suggests that we can use a phrase to "indicate all other systems are negative". Perhaps after stating all positives:" All other Review of Systems have been reviewed and are negative" or something along those lines.
You may still want to check with your carrier/payer, as some commercial payers might not accept such verbiage.
Hope this is helpful.