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Wiki Ros

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lsharp57

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My question is I have a provider who saw the patient in the hospital who was in the ICU and intubated. He was unable to speak. The physician documented that he could not document review of systems with the patient due to being intubated. The Physician wants to bill a 99223 for this visit however; with no ROS documented it brings the HPI down to an expanded problem focused HPI. What can be documented for the ROS to count in this situation?

LS
 
Your provider's statement is perfectly acceptable. Had they just said 'ROS unobtainable' without elaboration as to why, you would not accept it.

Assuming the rest of the documentation meets the requirements, you could bill a 99223.
 
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