June 2012

June 2012

One of the areas most highly scrutinized in a medical necessity audit is the taking of X-rays.

Some chiropractors will take X-rays for patient education or their report of findings presentation, rather than medical necessity. The three most important rationales to justify films and document in the patient's record are: 1) trauma, 2) red flags for infection or cancer, 3) and a scoliosis evaluation when clinical indicators are present.

Do you need to justify referral for an MRI? Make sure you have one of the indicators, such as lingering pain beyond four weeks, progressive or worsening neurological symptoms, or when fracture is strongly suspected, but not seen on plain film.

Make sure your patient's record reflects the need for films, and include a written report. No written report in a file = no medical necessity. Don't have a simple, easy to use X-ray report? The Paperwork Project offers one at no-charge by simply supplying your contact details.

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