Health Information Management

Did you know: CMS states physician query position in 2001 brief

CDI Strategies, June 11, 2009

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Government payers traditionally frowned on the idea of physician queries. Early on they believed queries opened opportunities for the inscrutable “leading” of physicians to document care they did not provide in order to receive increased reimbursement. But in 2001, CMS backed away from its earlier query dismissal to take a more open-minded approach to the physician query potential.
 
In an October 11, 2001 memorandum, CMS clarified its position. As described by the Texas Medical Foundation (TMF) Quality Institute, the quality integrity organization (QIO) for Texas CMS said:
“Use of the physician query form is permissible to the extent it provides clarification and is consistent with other medical record documentation.”
 
CMS’s position is that a query form should not
  • be leading
  • introduce new information not otherwise contained in the medical record



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