Physician Documentation
Patrick Nimphie
Description
Collection
Title:
Physician Documentation
Creator:
Patrick Nimphie
Date:
1/12/2012
Text:
Section 1833(e) of the social security act states that the prosthetic
patient's medical records (including the physician's office records) will
reflect the need for the prosthetics care provided. It is the treating
physician's record, not the prosthetists, that is used to justify payment.
It's my understanding this not only includes current functional (K-Level)
supporting documentation in the physician's record but also the
justification for components used in each particular case.
In region A, a prepayment audit was performed in mid 2011 and it resulted
in an 86.6% denial rate of payment for services provide by prosthetists due
to the lack of concurring support of medical justification in the physicians
record.
Can anyone provide information as to how they ensure the treating physician has
the required information in their patient record and are complying with
these requirements?
Patrick R. Nimphie, CPO, FAAOP
________________________________
Confidentiality Note: This e-mail, and any attachment(s) is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please contact the sender immediately and destroy the material in its entirety, whether electronic or hard copy. Thank you..
patient's medical records (including the physician's office records) will
reflect the need for the prosthetics care provided. It is the treating
physician's record, not the prosthetists, that is used to justify payment.
It's my understanding this not only includes current functional (K-Level)
supporting documentation in the physician's record but also the
justification for components used in each particular case.
In region A, a prepayment audit was performed in mid 2011 and it resulted
in an 86.6% denial rate of payment for services provide by prosthetists due
to the lack of concurring support of medical justification in the physicians
record.
Can anyone provide information as to how they ensure the treating physician has
the required information in their patient record and are complying with
these requirements?
Patrick R. Nimphie, CPO, FAAOP
________________________________
Confidentiality Note: This e-mail, and any attachment(s) is intended for use only by the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please contact the sender immediately and destroy the material in its entirety, whether electronic or hard copy. Thank you..
Citation
Patrick Nimphie, “Physician Documentation,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/233283.
