Physician's Order Requirements for Modified Barium Swallow Studies (radiology)

[Guest guest]

This question may not be for everyone (since it is really more about

orders for radiolgy than rehab), but for those of you who have knowledge

of this area, any insight would be appreciated. The CMS website &

medicare claims processing manual is kicking my rear on this topic! :-)

We are hospital-based outpatient & at times our STs will recommend an

MBSS. The way we have always done that is: on the first page of the ST

Eval (where we have the physician's signature box), the therapist will

write 'Recommend Outpatient MBSS, please sign if you agree'. The first

page has patient name, diagnosis, MR#, DOB, Physician's name, etc. The

Dr. signed & dated. We fax to the Dr. & then fax it to Radiology

scheduling once we get the signature (the patient is asked if they want

it done elsewhere, but the hospital is the only place in our city that

performs these; fyi). We have never had to go the route of having the

Dr. send us a specific script independent of this.

After many years, we were told by radiology last week that, that page

which has all pertinent information, " is not a valid order " . We checked

with our Director of Medical Records, thinking radiology may be mistaken

& he agreed with them (no specific regulations or by-law noted, just a

basic no answer).

I know where & how to find information for rehab, but can only find CMS

guidelines on billing & /or signature requirements, not 'what constitutes

an order'. I know there are many avenues within CMS, but have spent

quite a bit of time looking & nothing that I feel gives us any clear

indication 1 way or the other. I know there are other considerations,

aside from CMS, but feel this is where we need to start.

Again, anything to point me in the right direction would be appreciated!

Thanks,

Mike Kamp, Rehab Mgr, OMH Rehab, ville, NC