Healthcare Business Today Article by Kirti Reddy, Theresa DeAngelis Addresses Benefits of Documenting Medical Necessity for Health Care Services


Kirti Reddy and Theresa DeAngelis wrote an article for Healthcare Business Today about the legal benefits for health care providers in clearly documenting the medical necessity of the services they provide. Reddy is a partner in the Quarles & Brady Health & Life Sciences Practice Group and DeAngelis is an associate in the group; both are based in the firm’s Washington, D.C., office.

In the article, they emphasize that strong, accurate records regarding the medical necessity of services will help providers avoid any issues related to reimbursement by Medicare, Medicaid or other government payors. In an excerpt, Reddy and DeAngelis wrote:

Thus, proper documentation at the outset is essential. For medical providers, documenting medical necessity (as well as the Current Procedural Terminology codes and corresponding modifiers) justifies both the care required by the patient as well as the amount of reimbursement. Properly documenting medical necessity will stave off a potential whistleblower or government audit or investigation.

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