Please post on the L list. Thanks!!
I have some question's regarding the EDM and Medical Necessity. Our ER physicians are expressing some concern over the OE functions in the ER. We do have it setup for the doctors to answer some of the CDS with the procedures. Do you? However, they are also not pleased that they must enter a diagnosis on some procedures when ordered in the ED due to Medical Necessity. We ask the diagnosis code at order time so we only have to manage the exceptions rather than 100% ED claim review before they go out the door. If a ABN is printed because it does not met Medical Necessity we do not have the patient sign the form. We are using Administar (NGS) for our intermediary. Can you let me know how it was handled at your facility, or if it is even an issue? Thanks so much!!! Debbie Yerbic 210 W. Walnut Canton, Il 61520 309-647-5240 Ext. 2287
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