Licensed Clinician

I need to find the reference regarding accepting diagnoses from licensed professionals only.i.e. is it in Federal Register?

Comments

  • edited May 2016
    I have never seen a reference stating that BMI's can only be coded if documented by a "licensed clinician". It's my own coding department's interpretation of Coding Clinic 2nd qtr 2010 p. 15.

  • edited May 2016
    That is the same reference cited at our facility.

    Vivian


  • edited May 2016
    Sorry to be confusing. We have a situation here of an ID nurse who
    pre-populated a query for catheter related uti including the actual
    relationship and the organism and then left an email note, post-it note
    and phone call requesting that a specific MD sign it. Wrong, wrong,
    wrong. We do not LEAD physicians.

    That is the reference/citation I am searching for. I need to prove this
    to her and some leadership people. Therefore, I want a citation.

    Again, sorry for the confusion.

    Donna Kent, RN, BSN, CCDS
    Manager, Clinical Documentation Integrity Program
    Clinical Quality and Accreditation
    Torrance Memorial Medical Center
    ph.:310 784-6884 fax:310 784-6899
    donna.kent@tmmc.com

  • I would show them AHIMA's practice brief, "Managing an Effective Query Process." That is where we find the guidelines against leading queries, and AFAIK, that is the gold standard for query policies. As far as who may diagnose, that comes from ICD-9 CM Official Guidelines for Coding and Reporting, starting with, "In the context of these guidelines, the term provider is used throughout the guidelines to mean physician or any qualified health care practitioner who is legally accountable for establishing the patient’s diagnosis. Only this set of guidelines, approved by the Cooperating Parties, is official." I hope that's what you're seeking.


    Renee

    Linda Renee Brown, RN, CCRN, CCDS
    Senior Consultant, CDI/Nursing
    Jacobus Consulting, Inc.
  • edited May 2016

    Ahima practice brief.
  • edited May 2016
    Thank you all.

    Donna Kent, RN, BSN, CCDS
    Manager, Clinical Documentation Integrity Program
    Clinical Quality and Accreditation
    Torrance Memorial Medical Center
    ph.:310 784-6884 fax:310 784-6899
    donna.kent@tmmc.com
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