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ROS Question

  1. Default ROS Question
    Medical Coding Books
    I have a question say a doctor has in his ROS no cough, no sore throat, no fever, except all other ROS negative. Would you count that as 2-9 or a complete ROS?

    Thank you

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    My Medicare carrier allows a complete ROS with this statement.

  3. Default
    Thank you

  4. Default With one caveat
    If you are in an area where the Fiscal Intermediary is Trailblazer and this is a Medicare patient, the "all other systems negative" comment will not be acceptable

  5. #5
    Location
    Milwaukee WI
    Posts
    4,466
    Default Check YOUR carrier
    Please be sure to check with YOUR carrier as this is carrier-specific.

    Our carrier currently DOES accept this, but we've been notified that we'll be switching to Trailblazer next year and they DON't accept it. Training of MDs has started already.

    F Tessa Bartels, CPC, CEMC

  6. Default
    So what do you do for the commerical insurances? Do you just follow the Medicare rule for all your paitents?

    Thank you

  7. #7
    Location
    North Carolina
    Posts
    3,126
    Default
    Personally, I base all my chart review on CMS guidelines. 99.9% of my commerical carriers base their guidelines around CMS guidelines. Most of our local carriers state, on their websites , state that they mimic CMS guidelines...not our local MAC. When auditing Medicare patient's, I have to "weigh in" my local MAC's guidelines and CMS'. For the most part, their DG requirements are the same...there are only a few variations. My recommendation...follow CMS unless your local carriers, have in writing, that they adopt your local MAC requirements.
    Last edited by RebeccaWoodward*; 03-27-2009 at 07:24 AM.

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