decisionhealth Newsletters, Part B News - 2013 Issue 7 (July)
MACs, auditors crack down on signature requirements for ordered DME, tests
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Article Overview
This article covers Medicare documentation requirements for physician-ordered durable medical equipment and diagnostic tests, and why payers and auditors are focusing on signature support in the record. It is relevant to physician practices, coders, billing staff, compliance personnel, and consultants who handle order documentation, medical necessity support, and audit preparedness. The discussion includes Medicare manual guidance, workflow and EHR-related pitfalls, and examples of how organizations are responding to signature-related claim review.
Why This Topic Matters
Signature deficiencies on ordered services can create audit exposure and repayment risk, even when claims initially process. Understanding the documentation expectations helps practices strengthen compliance and reduce denials or recoupments tied to order records.
Article Sections
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Billing
Introduces the documentation issue and the payer scrutiny surrounding physician-ordered services. It frames the article’s focus on compliance risk for practices that submit claims for ordered items and tests.
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Workflow, timing among reasons for no signature
Discusses practice process problems that can lead to missing documentation support for orders. It also addresses office workflow, EHR use, and timing issues that can create audit vulnerability.
What You Will Learn
- The types of documentation concerns associated with physician-ordered DME and diagnostic testing
- How audit and review activity can affect claims with incomplete order records
- Common workflow and EHR issues that contribute to signature-related compliance problems
- General ways practices can improve documentation support for physician orders
Who Should Read This
- Physician practices
- Medical coders
- Billing staff
- Compliance teams
- Durable medical equipment suppliers
- Consultants and auditors
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