Survey: Documentation still a challenge

Friday, November 30, 2007

WASHINGTON - Two years have passed since CMS changed its documentation requirements for power mobility devices, but providers still report major difficulties, according to a recent NCART survey.
The lack of clarity surrounding the requirements has increased the burden on providers, delayed their ability to deliver PMDs and intensified their exposure to post-payment audits, respondents stated.
"This survey quantifies the confusion and the challenges still facing providers," said Don Clayback, NCART's secretary/treasurer. "While some of the requirements are defined and understood, there are still others that need clarification."
About 120 providers responded to the survey (Providers who rely on complex rehab for more than 40% of their business comprised 28% of respondents). NCART plans to use the results to prompt CMS to issue written guidance for providers and physicians.
On Nov. 15, 2005, CMS replaced CMNs with prescriptions and physician notes for PMDs. Much of the lack of clarity surrounding the requirements concerns what should be documented in those notes.
Thirty-seven percent of respondents reported that physicians "are frustrated by the complexity of the documentation and avoid prescribing PMDs" (See graph page 23).
Also according to the survey:
* A majority of respondents (26%) reported PMD claims were 11 to 15 pages long.
* A majority of respondents (31%) reported that it takes more than 30 additional days to provide PMDs under the requirements.
Clayback said "there are discussions already going on with CMS and the medical directors to resolve some of these issues."
"The survey bolsters some of the points we're already trying to make," he said.