Tag: Clinical Documentation
Clinical documentation: Look to LCDs for guidance
May 28, 2014Wayne van Halem
A. It seems like what they want and expect changes on a regular basis; however, most of the products you bill for have a local coverage determination (LCD). In that LCD is a section called “Coverage Indications, Limitations, and/or Medical Necessity.” This is essentially what Medicare expects to see in the clinical documentation. There are generally criteria listed that essentially says under these circumstances, Medicare will pay for this equipment. The clinical documentation must prove...
Clinical documentation: Choose your physicians wisely
November 26, 2013Wayne van Halem
A. I feel your pain and understand the challenge associated with this task. First, if the physician is telling you that no one else is asking for the documentation, he/she is probably not being truthful. Most providers in this current environment know the importance of obtaining documentation to support their claims, so hold that physician accountable.Remind them of their legal obligation to comply and provide the statute indicating that. Approach them from a compliance perspective. Indicate...