Was wondering how other coders see the following documentation?
These are inpatients and the requesting provider in a shared chart writes orders " Palliatvie care to consult"
The palliative care provider starts the report with:
" Palliative care consultation was requested by Dr XXXXX for management of pain for (a specific problerm.)"
Then the provider documents the HPI, ROS, PSFH, Exam and Impression, but instead of plan, the section's title is RECOMMENDATIONS.
Then in sharded chart will written order for medication.
I am from Nebraska, so WPS is our Medicare carrier and they are different from what we had before. So some of us is still wondering about the word "management, was being transfer of care or not.
Thank for any thoughts.
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