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ROS auditing trouble

  1. Default ROS auditing trouble
    Medical Coding Books
    I have run into a problem with my audits. For the history side of the audit there is: History of Present Illness, Review of Systems, and past, social, and family history. A lot of our patients cannot communicate with the Drs. regarding the ROS and this brings down the level of service they can charge for, due to brain injuries. According to CMS, the ROS is done by asking the patient direct questions. Usually family does not come with these patients. Do you know of any other rules that would apply to these kinds of patients so the docs can get paid for their hard work?

  2. #2
    Baltimore East, MD
    Depending on the insurance carrier, the physician might be able to receive credit for performing an ROS as long as they clearly state the reason they were unable to collect ROS from the patient, and any attempts they made to get information from family.

  3. Default
    We run into that at times as well. Usually though we can get information from the family, group home nurse, or even current notes from the group home or nursing home accompaning a patient to the office. We do document where the information has come from as well.

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