Which of the following would not be a required step in utilizing medical necessity guidelines?
A) review of the family history section of the progress note
B) review of the narrative diagnostic finding(s) indicated
C) review the order from provider
D) looking over the entire encounter form and progress note to make sure that all procedures and services and diagnoses are identified
Question 2
The AMA defines medical necessity as services or procedures that a prudent physician would provide to a patient in order to prevent, diagnose, or treat an illness, injury, or disease or the associated symptoms in a manner that is:
A) in accordance with the generally accepted standard of medical practice
B) clinically appropriate in terms of frequency, type, extent, site, and duration
C) not for the intended economic benefit of the health plan or purchaser or the convenience of the patient, physician, or other health care provider
D) all of the above
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