# Need help with ROS  ???



## mcarrillo (Mar 9, 2012)

Hi, 
When the doc states  "A comprehensive review of systems was negative.", does this count as 10+, or just one?

Thanks
Maria


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## rthames052006 (Mar 9, 2012)

Per the Documentation Guidelines for both 1995 and 1997 it states:

A complete ROS inquires about the system(s) directly related to the problem(s) identified in the HPI plus all additional body systems.

DG:  At least ten organ systems must be reviewed.  Those systems with positive or pertinent negative responses must be individually documented.  For the remaining systems, a notation indicating all other systems are negative  is permissible.  In the absence of such a notation, at least ten systems must be individually documented.

If what you have listed in your orignal thread is what is documented in this patient's note, I wouldn't give credit for a ROS.  There is no mention of anything.  What was the patient being seen for, may I ask?


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## Evelyn Kim (Mar 12, 2012)

I would not give credit for a ROS either.  that is like saying " all others negative"  it is not specific and does not meet the criteria.


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## cthompson1446 (Mar 12, 2012)

*Ros*

I found ths on the E/M University website:

E/M University Coding Tip: When documenting the ROS , it is not necessary to list each system individually.  It is acceptable to document a few pertinent positive or negative findings and then say: “All other systems were reviewed and are negative.

Hope that helps!


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## LisaV1202 (Apr 5, 2012)

*Need help with ROS ???*

I can't swallow how "all others negative" can get a Complete for ROS. 

Then why doesn't every doc do it that way & save a bunch of time by not having new patients fill out the forms. I'm sure most docs with an EMR put the same ROS in to get a higher level, too. I know it's in EMU but if it's not stated as ok in the DG's then I don;t like to use it. 

Anyone have anymore input or documents on this?


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## LLovett (Apr 6, 2012)

*All others negative is carrier specific but it is in the official guidelines*

WPS Medicare allows it, CMS allows it, but many other carriers do not.

https://www.cms.gov/Outreach-and-Ed...downloads//eval_mgmt_serv_guide-ICN006764.pdf

A complete ROS inquires about the system(s) directly related to the problem(s) identified
in the HPI plus all additional (minimum of ten) organ systems. Those systems with positive
or pertinent negative responses must be individually documented. For the remaining
systems, a notation indicating all other systems are negative is permissible. In the
absence of such a notation, at least ten systems must be individually documented.


1995 Guidelines:

http://www.cms.hhs.gov/Outreach-and...Network-MLN/MLNProducts/downloads//1995dg.pdf

complete ROS inquires about the system(s) directly related to the problem(s) identified in the
HPI plus all additional body systems.
!DG: At least ten organ systems must be reviewed. Those systems with positive or
pertinent negative responses must be individually documented. For the
remaining systems, a notation indicating all other systems are negative is
permissible. In the absence of such a notation, at least ten systems must be
individually documented.

1997 Guidelines:

http://www.cms.gov/Outreach-and-Edu...etwork-MLN/MLNProducts/downloads//MASTER1.pdf

A complete ROS inquires about the system(s) directly related to the problem(s)
identified in the HPI plus all additional body systems.
!DG: At least ten organ systems must be reviewed. Those systems with
positive or pertinent negative responses must be individually
documented. For the remaining systems, a notation indicating all other
systems are negative is permissible. In the absence of such a notation,
at least ten systems must be individually documented.

As you can see everything CMS posts on this is the same. Just check with your carrier to see what they say. I believe Trailblazer is one that does not allow it and I have been told NGS doesn't either but I have never personally verified if this is true or not.


And to the original question I would not give credit for any ROS. 

Laura, CPC, CPMA, CEMC


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## rthames052006 (Apr 13, 2012)

*Let's see....*

I think we may be confused by the original posters thread?  They don't tell us if the provider has any pertinent postiive or negative responses all the poster lists is " all other systems negative".

I think the original poster should clarify if what they have posted is the entire ROS or is this just one sentence from the ROS and the provider has documented pertinent positivies and negatives.

Does anyone agree here?


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## koatsj (Apr 13, 2012)

I have been through this numerous times with my surgeons. I found literature stating that you have to individually list all pertinent positive and negative systems and then the billing clinician can state-all other systems were negative _*after*_ reviewing all the systems.


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