Standing Order Sets for Clinical Nutrition Services

cstarnescstarnes
in GENERAL

Are standing order sets that include referrals for Clinical Nutrition Consults when a new oncology patient is seen in an OP Clinic support or meet requirements for medical necessity by payers? I am seeking guidance on whether this would/could be interpreted as "routine" if a standing order set and/or protocol is used for the CN consults even if it is for efficiency and best care of the patients.

Comments

  • dwilliamsrsidwilliamsrsi

    Any standing or protocol order set can be viewed as "routine" unless the physician/NPP documents the need for the individual patient. The key to supporting the medical necessity of any order is the documentation in the record. There has to be something documented that links the order to the need(s) of the individual patient in order to clarify the physician/NPP intent. This can be short and sweet. For example, Mr. A is being seen by the oncologist as a new patient and the planned treatment protocol produces nausea or taste change or ...... Because of Mr. A's limited food likes, he will see the clinical nutritionist to mitigate potential issues when treatment starts. (Of course, the specifics would be spelled out.) This shows that this individual patient is in need of the service and it isn't just something for "everyone."

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