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Chief Complaint Is a Must Have - AAPC Knowledge Center

    https://www.aapc.com/blog/42585-chief-complaint-required/
    An easily identifiable chief complaint is the first step in establishing medical necessity for services rendered. The 1995 and 1997 Documentation Guidelinesfor Evaluation and Management (E/M) Services specifically require, “The medical record …

A Refresher on Medical Necessity | AAFP

    https://www.aafp.org/pubs/fpm/issues/2006/0700/p28.html
    This code specifically identifies the patient as having some elements of chronic bronchitis, COPD and emphysema, and indicates that these clinical problems are not controlled. 3. …

Medical Necessity: Why It Matters, Ways to …

    https://www.aapc.com/blog/46500-medical-necessity-why-it-matters-ways-to-demonstrate-it/
    “Medical necessity” is difficult to define, with as many different interpretations as there are payers; …

The Missing Chief Complaint - AAPC Knowledge Center

    https://www.aapc.com/blog/28120-the-missing-chief-complaint/
    A common problem with provider documentation is the missing chief complaint (CC). CPT® defines the CC as “A concise statement describing the symptom, problem, condition, …

The Secret to Documenting for Medical Necessity | WebPT

    https://www.webpt.com/blog/the-secret-to-documenting-for-medical-necessity/
    How does the APTA define medical necessity? In 2011—prior to the Jimmo settlement, mind you—the APTA established its own definition of medical necessity in an …

Medical Necessity: Is It Really Necessary?

    https://www.aapc.com/blog/77660-medical-necessity-is-it-really-necessary/
    To reinforce medical necessity and meet payer guidelines, documentation should be complete, support the service(s) billed, and validate the need for the level of …

Patient Care: Medical Necessity and Patient Status

    https://compliancecosmos.org/patient-care-medical-necessity-and-patient-status-0
    Stays greater than 48 hours should rarely be considered an outpatient unless there are concerns regarding medical necessity. Any stay between 24 and 48 hours should be …

How to Document the Need for Cataract Surgery

    https://www.aao.org/eyenet/article/how-to-document-the-need-for-cataract-surgery
    1. Chief complaint. The patient’s chief complaint conveys symptoms, such as blurred vision, visual distor­tion, reduced contrast sensitivity, or complaints of glare associated …

Letter of Medical Necessity | Health …

    https://www.patientsrising.org/letter-of-medical-necessity/
    MEDICAL NECESSITY: Why is this treatment medically necessary? How will it prevent, diagnose, or cure conditions in the patient that endanger the patient’s life, …

Filing complaints about a doctor, hospital, or provider

    https://www.medicare.gov/claims-appeals/file-a-complaint-grievance/filing-complaints-about-a-doctor-hospital-or-provider
    To file a complaint about your doctor (like unprofessional conduct, incompetent practice, or licensing questions), contact your State medical board. Complaints about the quality of …



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