Synvisc One injectionable

Hi all,

Thoughts on documenting the Synvisc One. From a compliance perspective, I believe all units of any drug should be documented. This drug has a unit base of 48. Would you accept a procedure note that only states the brand name and not the units given? We have trained our providers for years to document the amounts in every procedure note.

Thank you,

Mary Flanery, CPC, CBCS, CHC
Quality Review Specialist
9600 Pulaski Park Drive Suite 103
Baltimore, Maryland 21220



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Comments

  • I recommend always to note the dosage and in some cases the manufacturer of the drug in the case of a recall.
    Maxine

    [Description: Description: R:\General\Graphics\ScrogginsGrear\Correct Colors\ScrogginsGrear One Line Signature.png]

    Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
    Main: 513-771-7070
    Direct: 513-672-4363
    Fax: 513-326-7640
    200 Northland Blvd
    Cincinnati, OH 45246
    mlewis@scrogginsgrear.com
    www.scrogginsgrear.com

  • ALWAYS document the units, even if it’s obvious to the MD and staff that it will always be 48. We were audited by Blue Cross and it was not a fun time. It was their contention that our Synvisc One injections (among other similar injections) were not adequately documented. Now we audit every chart note on the front end, and if the mgs are not documented, we have the MD dictate an addendum.

    Beth

    Beth Aldridge, CPC
    Coding Manager

    Northern California Medical Associates, Inc
    Phone: (707) 573-6145
    Fax: (707) 573-6932

  • Thank you for the answers Maxine and Beth. Much appreciated.

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