5H161: No Physician's Orders
Published 11/07/2019
This claim was fully or partially denied because there were no physician’s orders submitted for review for all or some of the services billed.
To Prevent This Denial
- A physician’s order should be submitted for review with the request for copies of medical records
- A legible signature is required on all documentation necessary to support orders and medical necessity
- The copy of the order should be legible and dated
- Make sure any orders submitted for review are for the dates of service billed
Resources
- Code of Federal Regulations, 42 CFR – Section 410.32
- CMS Internet-Only Manuals (IOMs), Medicare Program Integrity Manual, Publication 100-08, Chapter 3, Section 3.3.2.4 (PDF)