betsycpcp
Networker
I've searched here for previous answers on this but never seem to find exactly what I'm looking for-- if a provider indicates that they reviewed a previous Review of Systems and they give the date that it was done and where it's on file, I know guidelines say that is acceptable rather than doing a new ROS as long as they update or say there are no changes. All I want to know is how to determine what level to assign to the ROS if they don't say how many systems were reviewed or that it was a "complete" ROS.
I saw on previous answer in a forum that says since the previous ROS is listed with a date, that creates an audit trail so the level can be verified if necessary. However, what if that information is not available? Example- I work for a payer for workers' comp. The note refers back to ROS done on a date prior to the work injury. We would not have access to any records prior to or unrelated to the injury. So I don't know if it was a complete ROS or not since the note doesn't specify.
Also I always wonder about medical necessity. If the previous ROS was 10 or more systems because of the patient's complaint(s) at that time, but now they have a specific, straightforward complaint, why should the previous complete ROS count?
Just interested in any guidelines, references or opinions on this topic-- thanks!
I saw on previous answer in a forum that says since the previous ROS is listed with a date, that creates an audit trail so the level can be verified if necessary. However, what if that information is not available? Example- I work for a payer for workers' comp. The note refers back to ROS done on a date prior to the work injury. We would not have access to any records prior to or unrelated to the injury. So I don't know if it was a complete ROS or not since the note doesn't specify.
Also I always wonder about medical necessity. If the previous ROS was 10 or more systems because of the patient's complaint(s) at that time, but now they have a specific, straightforward complaint, why should the previous complete ROS count?
Just interested in any guidelines, references or opinions on this topic-- thanks!