Issue: Medicare is denying an increasing number of claims because documentation submitted for diagnostic tests does not include signed test orders or evidence of intent (MD progress notes listing tests needed) and evidence of medical necessity (description of clinical conditions and treatment showing the need for the testing).
Guidance: While the physician’s signature is not required when initially ordered for clinical diagnostic tests, upon review by Medicare contractors, there must be evidence to support the physician’s intent to order the tests performed and documentation of medical necessity is required. Claims may be denied if signatures, evidence of intent, and medical necessity are missing. If the physician signature is not legible on an order or progress note, providers may submit a signature log or attestation statement to support the identity of the illegible signature. For more information, please refer to the Medicare Learning Network® publication titled Complying With Medicare Signature Requirements Fact Sheet (PDF) .