Wiki Separate Documentation for Interpertation

kwiegscpc

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I work for an Othro phy and we are trying to sort out if he should be submitting a separate dictation for the xrays done or if he can include it in his orginal documentation. Any feedback??
 
Nelson is absolutely correct! There must be a separate radiologic interpretation report in the medical record. A student of mine recently relayed that their practice had to refund a significant amount of money to a commercial payer when it was discovered that her docs were pasting the sentence from their office note to a separate document to have that serve as a radiology report, apparently it did not!
 
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