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Medical necessity and overarching criterion

For any medical service to be reimbursed, medical necessity is the overarching criterion for payment
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For any medical service to be reimbursed, medical necessity is the overarching criterion for payment.

The volume of documentation should not be the basis for the level of service billed. A potential unintended consequence of electronic medical records is that documentation may be auto populated that is not medically necessary or appropriate for the presenting condition.

To justify the service billed, specific signs, symptoms or complaints are what make the services medically necessary or deemed as reasonable.

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