1. lydia rodriguez
   Posted 4 months ago #
   

   CAN YOU BILL A SURGICAL PROCEDURE (CYSTOSCOPY) IF THE WRITTEN NOTES WERE DISCARDED BEFORE IT COULD BE TRANSCRIBED. DR. RECONSTRUCTED THE REPORT FROM "NURSING NOTES" AND THIS IS NOTED ON THE REPORT?

2. SuperCoder
   Posted 3 months ago #
   

   There are different provisions to deal with the medical record loss (partially or completely) depending upon the state. Also there is no concrete regulation to deal with medical record loss due to carelessness of provider; however in case of disaster Medicare, FI or state agency may consider to reconstruct the medical record.
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   As per OIG guideline “Medical records (if in the possession of the physician practice) need to be secured against loss, destruction, unauthorized access, unauthorized reproduction, corruption, or damage.”

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   For further insight please check the following link
   http://www.cms.gov/MLNMattersArticles/downloads/SE1022.pdf
   http://www.ucop.edu/ucophome/coordrev/policy/legal-medical-record-policy.pdf
   http://rightnow.texmed.org/ci/fattach/get/7361/ (Pg – 6)
   http://classweb.intelliteccollege.com/VideosB/Medical/ResourceDocuments/MOA-LawEthics-fremgen_irm_ch09.pdf
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   Here I would like to suggest you to check with your FI or local Medicare carrier with written letter of request.
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   Thanks:

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