I believe this is a standing order, the blood is drawn in the office. Nothing other than the office visit is signed by the Dr. None of the patient problem lists, not the lab result, nothing but the OV, and it doesn't list the protime. That's where my problem lies. It's all over the chart that the protime is needed, and done, but no where is it signed. They feel they are okay with their documentation because it's in the chart. The previous 2 office visits do list the long term anticoagulation therapy, but not this particular visit. When we got a rejection on the protime, that's when we discovered the problem list issue. When we asked for documentation, it does not support a protime. As I said before, I was always taught that each visit should stand alone. The protime can be drawn on a standing order, and yes, is good for a year, BUT, shouldn't it be listed in the chronic conditions on the office visit notes that the patient had this done? Wasn't listed on the lab section either. Not that they discussed results, had anything drawn etc. Thanks everyone for your replies. I learn a lot from this forum!