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Non-contributory: where is written authority?

  1. #1
    Default Non-contributory: where is written authority?
    Medical Coding Books
    Hello,

    We all don't like "Family history: non-contributory" and don't allow it - it's common knowledge. However, my facility would like to have the written back-up as to why this is not allowed.

    I've looked through the various threads and written a few inquiries privately AND searched the Internet ... nada. A thought in the back of my head is that this was an OIG thing, but I can't find anything on that either.

    Does anyone have an article they can provide me the citation with or a specific carrier's dictum on that? We have Palmetto in CA and I could write a letter and ask it for clarification, but that might take a little time.

    Thanks much -
    Carol

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    This is my carrier's policy.

    Record Past/Family/Social History (PFSH) appropriately considering the clinical circumstance of the encounter. Extensive PFSH is unnecessary for lower-level services.

    Don't use the term "non-contributory".



    http://www.cignagovernmentservices.c...Article15.html

  3. #3
    Default
    Not to sound like a smart mouth but just give them the definition of the word.

    http://www.thefreedictionary.com/noncontributory

    I think it is pretty clear, this has nothing to do with medical care at all.

    This is WPSMedicare saying no to it.

    http://www.wpsic.com/medicare/part_b...isit_doc.shtml

    Good luck in your search,

    Laura, CPC

  4. #4
    Default
    WPS Medicare has also stated this terminology is not sufficient - http://www.wpsmedicare.com/part_b/pu..._history.shtml

    I don't see any policy like this for Palmetto.

    You may have to write to them.

    I just wrote to mine (NHIC) on this subject the other day. I'll keep you posted if/when I get a response.

    Erica

  5. #5
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    Lisa Bledsoe, CPC, CPMA

  6. #6
    Default
    I went to a coding event last summer and there it was said that the term "non-contributory" may be acceptable for PFSH, but not for the ROS.

    Unfortunately, right now I don't have anything in writing.

    I am also in NHIC territory (MA) -

    Erica - pls share what you find out, I'd be interested to see if they really do allow it and under which circumstances, considering that most other carriers don't.
    Thanks a bunch!
    Karolina, CPC, CPMA, CEMC

  7. #7
    Default
    For those in Highmark Medicare's jurisdiction, they have this topic addressed on their FAQ page at http://www.highmarkmedicareservices....rvices.html#19, question #24 which states, in part: "The use of the term "noncontributory" may be permissible documentation when referring to the remaining negative review of systems. The term "noncontributory" may also be appropriate documentation when referring to a patient's family history during an E/M visit, if the family history is not pertinent to the presenting problem." See the full text for the complete response.
    Jenny Berkshire, CPC, CEMC, CGIC

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