Suggestions on Getting Documentation From Physician's

Suggestions on Getting Documentation From Physician's

Melissa A. Bolton, Admin. Dept.

4/3/2013

Hey Everyone,

Can anyone give me some ideas/suggestions on how you are succesfully obtaining
detailed clinic notes from the physician's which include all of the specific
items such as K-level, desire to ambulate, and all of the other insane details
that Medicare is requiring be in the referring physician's clinical
documentation?

We are having a horrible time getting the physician's to be that detailed as
they tell us we are the experts in our field and we should be the ones that are
documenting these things, which of course, we agree with, but our hands are
tied.

I have a claim that is at Reconsideration level right now for one code, L2755,
light weigh material. It was originally denied as not a valid code which is
absolutely not correct and then at Redetermination, they denied it because the
referring physician's clinical documentation did not document why light weigh
material is necessary. ARE YOU KIDDING ME? How in the world are we to get a
physician to document why each and every LCode is necessary, especially when per
the LCD, the LCode is absolutely valid and billable with the base code it was
billed with. THIS IS RIDICULOUS!

Anyway, any suggestions, ideas, pointers, forms that you all may be using that
are helping you to successfully accomplish obtaining all this paperwork from the
referring physician would be extremely helpful.

Thanks in advance!

Melissa L. Bolton
Funding Assistant