Cardiology Coding Alert

Answer: Signatures are a crucial part of a patient’s medical record, and while most payers require a signature, there are situations where the timing may be adjusted, as long as there’s documentation to explain why. The Centers for Medicare & Medicaid Services (CMS) requires a provider’s signature to authenticate the services provided or ordered, explains.

Medicare Administrative Contractor (MAC) Palmetto GBA. Although individual payers may have different rules, many follow the standards put forth by CMS.

“The purpose of a rendering/treating/ordering practitioner’s signature in patients’ medical records, operative reports, orders, test findings, etc., is to demonstrate that services submitted to Medicare have been accurately and fully documented, reviewed, and authenticated. Furthermore, it confirms the provider has certified the medical necessity and reasonableness for the service(s) submitted to the Medicare program for payment consideration,” Palmetto GBA says.