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Wiki ROS question/auditing
- Thread starter jpinelli
- Start date
ARCPC9491
True Blue
Check with your contractor. Trailblazer doesn't allow it.
There are 14 systems .... if you say 10 system review -- what systems are you reviewing? This is why Trailblazer wants you to list them individually.
You also have a liability here ... providers may just be saying "all reviewed" to get a complete ROS. But also, say you have a patient that walks out of your office and has a heart attack and your ROS says positive for fever, all other reviewed and are negative? Many providers are NOT using this "short cut" because it is indeed a liability/malpractice to them if they abuse it.
Food for thought.
There are 14 systems .... if you say 10 system review -- what systems are you reviewing? This is why Trailblazer wants you to list them individually.
You also have a liability here ... providers may just be saying "all reviewed" to get a complete ROS. But also, say you have a patient that walks out of your office and has a heart attack and your ROS says positive for fever, all other reviewed and are negative? Many providers are NOT using this "short cut" because it is indeed a liability/malpractice to them if they abuse it.
Food for thought.
RebeccaWoodward*
True Blue
I agree with AR...check with your carrier. My carriers view.....
Complete ROS Examples
Chief complaint=shortness of breath
“No chest pain or cough. All other systems were reviewed and were negative.”
Systems reviewed:
If a complete review of systems is medically necessary, then at least ten organ systems must be reviewed:
Those systems with positive or pertinent negative responses must be individually documented.
For the remaining systems, a notation indicating all other systems are negative is permissible. In the absence of such a notation, at least ten systems must be individually documented.
Complete ROS Examples
Chief complaint=shortness of breath
“No chest pain or cough. All other systems were reviewed and were negative.”
Systems reviewed:
If a complete review of systems is medically necessary, then at least ten organ systems must be reviewed:
Those systems with positive or pertinent negative responses must be individually documented.
For the remaining systems, a notation indicating all other systems are negative is permissible. In the absence of such a notation, at least ten systems must be individually documented.