Wiki New patient audit

[jkluck]

A new patient was seen by physician. No lab/diagnostic test or x-rays were ordered. In doing an audit there was "insufficient supporting documentation" to code out. Our physician did not see the need to order labs/x-ray or any other test. If an external audit would be done on this visit we would fail. A "NEW" patient visit does not always warrant tests, but should still be able to be billed out as such. Any help is appreciated.

 

[mhstrauss]

A new patient was seen by physician. No lab/diagnostic test or x-rays were ordered. In doing an audit there was "insufficient supporting documentation" to code out. Our physician did not see the need to order labs/x-ray or any other test. If an external audit would be done on this visit we would fail. A "NEW" patient visit does not always warrant tests, but should still be able to be billed out as such. Any help is appreciated.

Who performed the audit? I agree that a New Patient visit DOES NOT require any type of tests to be ordered to justify the "new patient" categorization. What visit level was coded, and what level recommended by the auditor? What exactly is your question?