Physician Note requirements for Prosthesis
Tony Gutierrez
Description
Collection
Title:
Physician Note requirements for Prosthesis
Creator:
Tony Gutierrez
Date:
8/30/2012
Text:
A question for all.
Please review the following excerpt then see the question at the bottom
According to the Medicare Program Integrity Manual Chapter 5 - Items and
Services having Special DME Review Considerations
<URL Redacted>
Section 5.7 Documentation in the Patient's Medical Record:
For any DMEPOS item to be covered by Medicare, the patient;s medical
record must contain sufficient documentation of the patient's medical
condition to substantiate the necessity for the type and quantity of
items ordered...... The information should include the patient's
diagnosis and other pertinent information including, but not limited to,
duration of the patient's condition, clinical course, prognosis, nature
and extent of functional limitations, other therapeutic interventions,
and results, past experience with related items etc. (Can all be found
in Dear Physician Letter August 2011)
It then goes on to say:
There _*must*_ be information in the patient's medical record that
supports the medical necessity for the item and substantiates the
answers on the CMN, DIF, or information on a supplier prepared statement
or physician attestation. _
__*My questions*__*are:*_
1. Does any of the information in this section of the document put the
onus on the physician to have better quality notes?
2. Is there any ramification on the physician if their notes are not up
to the par set in these statements and the Dear Physician letter?
3. Can the RAC/Pre-payment/etc (audits) that are performed on us as
suppliers lead to an audit of a physician based on poor note quality for
support of a DMEPOS related item?
Please serious responses only, no complaints for the sake of complaining
about the unjustness of the situation.
Thank you,
Tony Gutierrez
--
Tony Gutierrez
Post-Resident Prosthetist
Orthotic Prosthetic Specialists
********************
To unsubscribe, send a message to: <Email Address Redacted> with
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message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Please review the following excerpt then see the question at the bottom
According to the Medicare Program Integrity Manual Chapter 5 - Items and
Services having Special DME Review Considerations
<URL Redacted>
Section 5.7 Documentation in the Patient's Medical Record:
For any DMEPOS item to be covered by Medicare, the patient;s medical
record must contain sufficient documentation of the patient's medical
condition to substantiate the necessity for the type and quantity of
items ordered...... The information should include the patient's
diagnosis and other pertinent information including, but not limited to,
duration of the patient's condition, clinical course, prognosis, nature
and extent of functional limitations, other therapeutic interventions,
and results, past experience with related items etc. (Can all be found
in Dear Physician Letter August 2011)
It then goes on to say:
There _*must*_ be information in the patient's medical record that
supports the medical necessity for the item and substantiates the
answers on the CMN, DIF, or information on a supplier prepared statement
or physician attestation. _
__*My questions*__*are:*_
1. Does any of the information in this section of the document put the
onus on the physician to have better quality notes?
2. Is there any ramification on the physician if their notes are not up
to the par set in these statements and the Dear Physician letter?
3. Can the RAC/Pre-payment/etc (audits) that are performed on us as
suppliers lead to an audit of a physician based on poor note quality for
support of a DMEPOS related item?
Please serious responses only, no complaints for the sake of complaining
about the unjustness of the situation.
Thank you,
Tony Gutierrez
--
Tony Gutierrez
Post-Resident Prosthetist
Orthotic Prosthetic Specialists
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
Tony Gutierrez, “Physician Note requirements for Prosthesis,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 24, 2024, https://library.drfop.org/items/show/234297.
