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OPERATIVE NOTE DIAGNOSIS AND CHART IMPRESSIONS MUST MATCH

8/4/2015

 
Applies to: Clinical; Billing; Clinic Supervisors, Front Office Leads
 
Clinical Assistants and Billing Staff – Please note that the “Impressions”(Diagnosis) listed in the chart notes must correspond with the Diagnosis’ listed in the Operative Report for all procedures, including injections, of course.
 
If you are the Assistant for a procedure and you see that this is not the case, please immediately bring this to the attention of the physician so that he can correct it; if you are a member of the billing department and see this in the course of your duties, please request a review or an addendum of the note by the rendering physician and copy the Billing Lead, Clinic Leads, Scheduling Lead and CEO.
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