Skip to Main Content
 
 
 
Web Content Viewer

Comprehensive Error Rate Testing

Web Content Viewer

Diagnostic Mammography

Insufficient Documentation Causes Most Improper Payments. Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for diagnostic mammogram.

    • Missing the authenticated physician order
    • Missing the documentation to support the medical need for the diagnostic mammogram
    • Missing the authenticated radiology report

Physicians order: Must be signed, dated, and indicate if unilateral or bilateral.

Supportive Documentation: The signed physician progress note that should indicate one of the following conditions. A patient has distinct signs and symptoms for which a mammogram is indicated; patient has a history of breast cancer; or patient is asymptomatic but, on the basis of the patient’s history and other factors the physician considers significant, the physician’s judgment is that a mammogram is appropriate.

Radiology Report: Must be signed and dated by the physician.

Related Content

Diagnostic Mammography
Web Content Viewer
Complementary Content