Search found 59 matches

by fjohnson
Fri May 11, 2018 5:14 pm
Forum: Medical Auditing Forum
Topic: Extracorporeal Photopherisis (ECP) - CPT 36522
Replies: 2
Views: 1010

Re: Extracorporeal Photopherisis (ECP) - CPT 36522

Thank you for the information. Do you have a primary source reference for this guidance? Additionally, if the initial treatment failed in 2016 and the patient is ordered to have ECP several times in 201 & 2018 must the initial failure be documented each time or is it enough that it is documented in ...
by fjohnson
Wed May 02, 2018 2:40 pm
Forum: Medical Auditing Forum
Topic: Extracorporeal Photopherisis (ECP) - CPT 36522
Replies: 2
Views: 1010

Extracorporeal Photopherisis (ECP) - CPT 36522

According to Medicare's NCP, ECP is covered as a second line treatment for certain dx when other treatments have failed. What needs to be documented in medical record to support treatment failure?
by fjohnson
Wed Mar 21, 2018 4:07 pm
Forum: Medical Auditing Forum
Topic: Documentation for Prolonged Services - 99358
Replies: 1
Views: 1105

Documentation for Prolonged Services - 99358

What supporting documentation is needed to support prolonged services CPT code 99358 w/o contact? If a provider documents the time spent in reviewing outside hospital tests, office notes and lab information to support prolonged services is this sufficient
by fjohnson
Thu Mar 30, 2017 12:39 pm
Forum: Medical Auditing Forum
Topic: Using Genetic Counselors note to support service
Replies: 1
Views: 972

Using Genetic Counselors note to support service

Hello, I have a question regarding genetic counselors documentation. If a attending physician copies a genetic counselors documented history of present illness, adds a few sentences to it and states "I verified the above information with the genetic counselor and family", can the copied HPI from the...
by fjohnson
Fri Mar 03, 2017 12:12 pm
Forum: Medical Auditing Forum
Topic: Nerve Conduction Studies - LCD Documentation Requirements
Replies: 1
Views: 1000

Nerve Conduction Studies - LCD Documentation Requirements

Good afternoon,

Is documentation of the skin temperature and type of needle required to support Nerve Conduction studies? Please include any relevant source information.

Thank you.
by fjohnson
Wed Feb 22, 2017 5:03 pm
Forum: Medical Auditing Forum
Topic: PT/OT/SLP - Referring physician signing the evaluation
Replies: 0
Views: 1746

PT/OT/SLP - Referring physician signing the evaluation

Good afternoon,

Is it required for the ordering/referring physician to sign the PT/OT/SLP documented evaluation or re-evaluation note certifying the plan of treatment is accurate and the services are medically necessary?
by fjohnson
Wed Feb 22, 2017 10:27 am
Forum: Medical Auditing Forum
Topic: Cleft Palate - MDM
Replies: 1
Views: 979

Cleft Palate - MDM

Good morning, If a 15 year old patient is being evaluated for a bilateral cleft palate from birth and the provider does not document any complications, should this be counted as one stable chronic condition (dx and mgt. options) and one stable illness (low risk)? The exam is problem focused in which...
by fjohnson
Tue Feb 21, 2017 11:00 am
Forum: Medical Auditing Forum
Topic: Documentating Pain Management - CPT 01996
Replies: 3
Views: 1567

Re: Documentating Pain Management - CPT 01996

Good morning, Could someone help me with the following follow-up question? I understand the RN documenting without documentation from the attending does not support billing the service under the attending. The RN is documenting basic information such as site of catheter, vitals, etc. and the attendi...
by fjohnson
Thu Feb 16, 2017 9:38 am
Forum: Medical Auditing Forum
Topic: Office visit and infusion on the same day
Replies: 0
Views: 1794

Office visit and infusion on the same day

Good morning, Could someone provide examples that would support a separately identifiable office visit when a patient presents for a routine Belatacept infusion? The scenario is patients are receiving monthly routine maintenance Belatacept infusions as a part of post transplant treatment and the pro...
by fjohnson
Wed Feb 15, 2017 12:55 pm
Forum: Medical Auditing Forum
Topic: Orders for Nerve Conduction Studies & EMGs
Replies: 0
Views: 1581

Orders for Nerve Conduction Studies & EMGs

Are orders required for EMGs/Nerve Conduction studies? If a provider who is performing the NCS/EMG and interpretation documents in the note the referring provider and EMG was requested for evaluation of ....., is this sufficient for an order/request for EMG? Please provide a sited source if available.