tci Medicare Compliance & Reimbursement - 2011 Issue 3

Reader Questions: You Will Need a Diagnosis Code for a Feigned Illness

Question: Our practice recently had a new patient present with a complaint of severe low back pain. When our nurse practitioner completed the history and physical exam, she suspected the patient of malingering and potentially misrepresenting his complaints to obtain a narcotic prescription. The staff informed the patient of the practice's required policy of reviewing the prior provider's notes, a signed narcotic agreement, and random urine drug screen (UDS) testing. The patient declined the UDS and chose to leave; the entire visit took about six minutes. I still need to code for the encounter. What should I report for...

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