Many healthcare professionals use these terms interchangeably. Medical decision-making specifically refers to the complexity of establishing a diagnosis and/or selecting a management option. Medical necessity refers to the appropriateness of the service provided for a certain condition. Medical necessity determines whether the service will get reimbursed. Problems arise with training…
EDITOR’S NOTE:  Dr. Erica Remer reported this story live during the January 14 edition of Talk Ten Tuesday. The following is an edited transcript of her reporting. When I do my Case Western Reserve University documentation course, I sometimes joke about the future, when we won’t need to document because the…
“Medical necessity” is a much-used but often-misunderstood concept. After our recent four-part series on the “Pitfalls of an Audit” and our last Talk Ten Tuesdays segment on the series, I had taken a position on medical decision-making (MDM) of the evaluation and management (E&M) record being the overarching criteria for…
Early documentation instruction sorely lacking Last week, during ICD10monitor’s Talk Ten Tuesdays broadcast, Larry Field, DO, treasurer of the American College of Physician Advisors (ACPE), shared the tale of a relatively new hospitalist who was disenchanted with medicine and considering a transition into physician advising after only three years of…