Orthopedic Coding Alert
Review Your ROS Levels
Question: What is meant by the review of systems (ROS) levels? California Subscriber Answer: Four ROS levels contribute to the level of history selected for an E/M service code. ROS progresses from -nonavailable- or -nonapplicable- to -problem-pertinent- to -extended- and -complete.- In a problem-pertinent ROS, your orthopedist asks questions about the system directly related to the problem identified in the history of present illness (HPI). When the physician asks about a limited number of additional systems, he meets the criteria for an extended ROS. Important: Extended ROS documentation must include positive responses and pertinent negatives for two to nine systems, according to both the 1995 and 1997 Documentation Guidelines for E/M Services. A complete ROS requires inquiring about all organ systems. The physician must review at least 10 organ systems and individually document those systems with positive responses and pertinent negatives. Tip: For the remaining systems, the orthopedist can use a notation to indicate that all other systems are negative. Without such a notation, he must individually document at least 10 systems for the documentation to support a complete ROS.
Orthopedic Coding Alert
- Shoulder Surgery Clinic:
Take a Swing at 3 Shoulder Coding Scenarios
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Consult Request Doesn't Have to Name Names
Question: How specific must a consult request be? I know there must be a specific [...] - Reader Question:
'One Size Fits All' Fee Schedule Isn't Required
Question: Must we bill all patients at the same rate? Pennsylvania Subscriber Answer: Technically, no, [...] - Reader Question:
Review Your ROS Levels
Question: What is meant by the review of systems (ROS) levels? California Subscriber Answer: Four [...] - Reader Question:
Watch Compartments for Meniscectomy/Synovectomy
Question: My orthopedist performed a lateral and medial meniscectomy and a partial synovectomy in the [...] - Reader Question:
Multiple Screws Still Only One Code
Question: My orthopedist documented that he removed three screws through three separate incisions at the [...] - Reader Question:
Post-Op Brace Fitting and Education Is Separate
Question: Can my physician bill for a fitting and education of a brace during the [...] - Reader Question:
25605 or 25606, but Not Both
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Which Code for Knee Hematoma?
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Rhonda Buckholtz, CPC: Avoid 7 Common Medicare Billing Errors -- Here's How
Take a few simple steps to ensure clean claims and proper payments The Administrative Simplification [...] - Clip-and-Save Bonus:
Simplify Your Place-of-Service Coding With This List
Fingertip guide to your most common POS eliminates confusion Choosing the correct place-of-service (POS) code [...] - Reader Question:
Confirm Diagnosis Before You Report It
Question: If the physician hasn't indicated x-ray results in his final diagnosis, should I code [...] - Brush Up on Your ICD-9 Know-How With 1 Tip
It's time to replace the outdated ICD-9 codes with the new and revised diagnosis codes, [...]
