jvargocpc
Networker
Hi!
We have an ophthalmologist who documents " +2 NS" on his H&Ps prior to cataract surgery.
Is this enough documentation to code a senile cataract when under his impression he just says "cataract"?
I'm not comfortable making the connection between NS and senile cataract, especially when he doesn't document "senile cataract", but I'm looking for confirmation one way or the other.
Thanks in advance for any help!
We have an ophthalmologist who documents " +2 NS" on his H&Ps prior to cataract surgery.
Is this enough documentation to code a senile cataract when under his impression he just says "cataract"?
I'm not comfortable making the connection between NS and senile cataract, especially when he doesn't document "senile cataract", but I'm looking for confirmation one way or the other.
Thanks in advance for any help!