DecisionHealth, DecisionHealth - 2017 Issue 7 (July)

Does ‘the patient’s wife insisted’ meet medical necessity?

Question: A doctor's note on a patient taking treatment for a shingles outbreak reads, "I did not recommend I&D [incision and drainage], but the patient's wife insisted." Is the provider admitting a lack of medical necessity, rendering the procedure unbillable to insurance (Medicare or other)?

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