"Notes must stand alone"

If your posts are directly related to compliance issues related to OIG, Stark, creating a Compliance Plan, compliance policies, or any other type of compliance need- post here. Also, check out the threads and add your comments to the threads here.

Moderators: NAMAS Moderator, Shannon DeConda

Post Reply
Posts: 48
Joined: Sat Dec 20, 2014 9:32 pm

Mon Mar 06, 2017 7:43 pm

Hello! We are trying to locate where the phrase "all notes must stand alone". We see this statement often, but are unclear as to where it comes from. Is it a CMS directive? We have been unable to find anything while searching their website. Thank you in advance for any guidance and/or direction you can give.

Sat Apr 22, 2017 1:15 am

Hello Jjones.

I finally found where the phrase came from. It is from First Coast Service Options, Inc. (FCSO). Their MD director published this memo back in 2006. See attachment.

It seems to pertain to late entries and addendum.
First Coast Medicare - Note.pdf
(72.88 KiB) Downloaded 1131 times

Fri Apr 28, 2017 12:12 pm

In addition, Noridian, our carrier, presented this webinar back in March/April 2016.

This is an excerpt from p.62 of the attachment,

Documentation Doesn’t Support Level Billed
•Each encounter must tell a complete story
•Prior encounters cannot be considered unless referenced by date in the encounter being audited

So, although it doesn't explicitly state "Notes must stand alone," it does come close.
(912.39 KiB) Downloaded 2430 times
Post Reply