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ROS question/auditing

  1. Default ROS question/auditing
    Medical Coding Books
    Can you please tell me if stating "all others reviewed and negative" is the only acceptable statement to receive full credit under the ROS? I am seeing other verbiage used such as " other 10 system review performed, no other pertinent positive responses".

  2. #2
    Check with your contractor. Trailblazer doesn't allow it.

    There are 14 systems .... if you say 10 system review -- what systems are you reviewing? This is why Trailblazer wants you to list them individually.

    You also have a liability here ... providers may just be saying "all reviewed" to get a complete ROS. But also, say you have a patient that walks out of your office and has a heart attack and your ROS says positive for fever, all other reviewed and are negative? Many providers are NOT using this "short cut" because it is indeed a liability/malpractice to them if they abuse it.

    Food for thought.

  3. #3
    North Carolina
    I agree with AR...check with your carrier. My carriers view.....

    Complete ROS Examples

    Chief complaint=shortness of breath

    “No chest pain or cough. All other systems were reviewed and were negative.”

    Systems reviewed:
    If a complete review of systems is medically necessary, then at least ten organ systems must be reviewed:
    Those systems with positive or pertinent negative responses must be individually documented.
    For the remaining systems, a notation indicating all other systems are negative is permissible. In the absence of such a notation, at least ten systems must be individually documented.

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