5T072, 5F072: No Physician Order for Services or More than Ordered

The claim has some of the services denied due to insufficient physician's orders, or the order was not obtained prior to the services being rendered.

How To Prevent This Denial

• When responding to an ADR, verify orders for all services rendered and billed are included with the medical records
• Ensure physician orders for all services billed are obtained prior to providing the service and prior to billing the final payment claim to Medicare

More Information

• Code of Federal Regulations, 42 CFR - Sections 424.22 and 409.43
• CMS Internet-Only Manuals (IOMs), Pub 100-02, Medicare Benefit Policy Manual, Chapter 7, Sections 30.2.1, 30.2.2, 30.2.4 and 30.2.5 (PDF)