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That ROS phrase is....borderline at best. I would strongly advise educating the provider about the CMS-approved version of that shortcut (NOTE THAT TRAILBLAZER DOES NOT ACCEPT IT.) The provider can simply document their positive findings, and pertinent negatives pertaining to the chief complaint, and then a notation that all other systems are negative. That will give them credit without having to individually list out all the other negative systems.
Other similar phrases that I see all the time and advise my physicians to change include:
"No other complaints today"
"10-point-ROS-negative"
"ROS negative in detail"
"ROS Negative except as per HPI"
You might get some insurances who will accept these phrases, so I hesitate to mark them down on my audit, but I always discuss it with them during a follow-up training session to drive home the point.
Mike - great advice. I like the way you explain things. But I still have to ask, when a provider writes ROS o/w negative x 10pts... or Otherwise negative x 10points. Which 10 systems were reviewed? There are 14 CMS recognized systems. WPS does not recognize 10 point review unless you specifically state which 10 were reviewed.
I agree, since there are 14 systems recognized, a statement that a 10-point system review was negative does not make it clear to the auditor or another medical professional which systems were reviewed. Some carriers may still give credit for that statement - but I personally don't like it.
Can anyone tell me where I can find the above info on the WPS website? Specifically the " CMS-approved version of that shortcut" and " WPS does not recognize 10 point review unless you specifically state which 10 were reviewed." We have always been instructed not to use "all others negative" or "all others negative as per HPI". We've always accepted "10 of 14 systems reviewed" as a complete ROS. I can't find the documentation for the WPS or CMS version of "all others negative" which we have been told to count as a full review of systems.
thanks
She does say multiple times that it is acceptable to say "all other systems are negative." She is understandably cautious about the potential for misuse or overuse. However, they do accept and recognize that CMS-approved shortcut for documenting a complete ROS.