Exactly. This is a record integrity and documentation improvement issue more than a coding issue. Orders must state why the service is being performed. Additionally, providers should provide the clear medical necessity for those services they perform or request.
First off, ensure that your provider orders (even if from outside your organization) meet the minimal qualifications of complete: legible, include clear medical necessity (dx or reason), referring provider name, and dates, times and appropriate signatures.
Secondly, do not hesitate to kick back orders that are incomplete or inappropriate. If they are from your internal providers, ensure that education is going on with those folks.
Lastly, educate on any denials or problematic claims and go back to the order or patient record to demonstrate to the providers why the problems arise. In this way you are completing the circle and those denied claims don't go to total waste.
Clinically, these patients are probably anemic. However, it's coaxing this out of the providers that is key to coding these properly and in sufficient detail and finally submitting them for payment. Hopefully this will help some.
