# Non-contributory: where is written authority?



## Yarbs (Jul 10, 2009)

Hello,

We all don't like "Family history: non-contributory" and don't allow it - it's common knowledge.  However, my facility would like to have the written back-up as to why this is not allowed.

I've looked through the various threads and written a few inquiries privately AND searched the Internet ... nada.  A thought in the back of my head is that this was an OIG thing, but I can't find anything on that either.

Does anyone have an article they can provide me the citation with or a specific carrier's dictum on that?  We have Palmetto in CA and I could write a letter and ask it for clarification, but that might take a little time.  

Thanks much - 
Carol


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## RebeccaWoodward* (Jul 10, 2009)

This is my carrier's policy.

*Record Past/Family/Social History (PFSH) appropriately considering the clinical circumstance of the encounter. Extensive PFSH is unnecessary for lower-level services. *

Don't use the term "non-contributory". 



http://www.cignagovernmentservices.com/partb/claims/cert/Articles/Article15.html


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## LLovett (Jul 10, 2009)

Not to sound like a smart mouth but just give them the definition of the word.

http://www.thefreedictionary.com/noncontributory

I think it is pretty clear, this has nothing to do with medical care at all.

This is WPSMedicare saying no to it.

http://www.wpsic.com/medicare/part_b/publications/home_visit_doc.shtml

Good luck in your search,

Laura, CPC


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## Erica1217 (Jul 10, 2009)

WPS Medicare has also stated this terminology is not sufficient - http://www.wpsmedicare.com/part_b/publications/em_history.shtml 

I don't see any policy like this for Palmetto. 

You may have to write to them.  

I just wrote to mine (NHIC) on this subject the other day.  I'll keep you posted if/when I get a response. 

 Erica


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## Lisa Bledsoe (Jul 10, 2009)

Also stated by TrailBlazer:
http://www.trailblazerhealth.com/Pu... preventing most common e-m coding errors.pdf


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## Karolina (Jul 10, 2009)

I went to a coding event last summer and there it was said that the term "non-contributory" may be acceptable for PFSH, but not for the ROS. 

Unfortunately, right now I don't have anything in writing.

I am also in NHIC territory (MA) -

Erica - pls share what you find out, I'd be interested to see if they really do allow it and under which circumstances, considering that most other carriers don't. 
Thanks a bunch!


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## j.berkshire (Jul 13, 2009)

For those in Highmark Medicare's jurisdiction, they have this topic addressed on their FAQ page at http://www.highmarkmedicareservices.com/faq/partb/pet/lpet-evaluation_management_services.html#19, question #24 which states, in part:   "The use of the term "noncontributory" may be permissible documentation when referring to the remaining negative review of systems. The term "noncontributory" may also be appropriate documentation when referring to a patient's family history during an E/M visit, if the family history is not pertinent to the presenting problem."  See the full text for the complete response.


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