denial management

sbeatty

We have Medicare supplemental carriers denying cases because the
consultant documents a dx and treatment plan, but the attending doesn't
include it in the DC Summary. How are others handling this issue, or
have you had this occur? Coding Clinic is very specific that the
attending doesn't have to reiterate the consultant's findings, he just
needs to not contradict or override that opinion. What are your
organizations doing to combat this sort of denial? Thanks.



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Columbus Regional Hospital
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catladyrn

Heck, never mind the auditors, I've seen our own coders refuse to document a diagnosis that was written by the consultant and not picked up by the attending. It's almost to the point where I feel like we should ask the attendings to start co-signing the consultants' notes.

Renee


Linda Renee Brown, RN, CCRN, CCDS
Certified Clinical Documentation Specialist
Banner Good Samaritan Medical Center

tpeyton

amen to that one.

Tracy M Peyton RN, CCDS
Case Management
Bradford Regional Medical Center
Upper Allegany Health Systems
116 Interstate Parkway
Bradford, PA 16701
814-558-0406