2022 Gastroenterology Reimbursement and Coding Update: Concrete Solutions to Strengthen Your Foundation in GI Coding and Billing (On-Demand) | 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

The video is a presentation on the importance of documenting medical necessity in order to survive audits and ensure payment for services. The speaker discusses various topics related to medical necessity, including diagnostic EGD policies, fusion services, medical necessity for E&M services, principles of medical record documentation, and endoscopy tips. The speaker emphasizes that medical necessity should be clearly documented in the patient's records to support the services provided and submitted on a claim. Without medical necessity, services may not get preauthorization or payment, and previously paid services may need to be recouped. The speaker also provides specific information on various procedures and their billing guidelines, such as multiple polyp removal, modifiers for unusual procedures, billing for different techniques used, and the importance of documenting specific locations and symptoms. The speaker concludes by advising providers to list symptoms requiring diagnostic evaluation, ensure complete and legible documentation, stay updated on payer policies, and share information with all relevant staff members.

Asset Subtitle

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

Keywords

medical necessity

audits

payment

documentation

EGD policies

E&M services

endoscopy tips