2022 Gastroenterology Reimbursement and Coding Update: Concrete Solutions to Strengthen Your Foundation in GI Coding and Billing | November 2021-The Key to Economic Success: Perfecting Proper Documentation for Medical Necessity

The Key to Economic Success: Perfecting Proper Documentation for Medical Necessity

Video Transcription

Video Summary

In this video, the speaker emphasizes the importance of documenting medical necessity to ensure proper reimbursement and avoid audits. They discuss various topics related to medical necessity, such as diagnostic EGD policies, infusion services, and the principles of medical record documentation. The speaker highlights the need to provide detailed documentation for each patient encounter, including the reason for the encounter, history and physical exam, assessment, impression, plan of care, and date and identity of the observer. They also provide tips for endoscopic billing, including the appropriate use of modifiers for multiple polyps, unusual procedures, and control of bleeding. The importance of documenting specific symptoms, indications, and locations for each procedure is emphasized. Finally, the speaker suggests staying up to date with payer policies and sharing information with providers, pre-authorization staff, and billing and coding staff to ensure accurate and timely reimbursement. No credits are granted in the transcript.

Asset Subtitle

Kathleen A. Mueller, RN, CPC, QMC, QGMC, CCS-P, ICD-10 Proficient

Keywords

medical necessity

reimbursement

audits

documentation

EGD policies

infusion services

endoscopic billing