Overview

The Rule Out (r/o) option lets clinicians document diagnostic uncertainty without affecting billing, claims, or reports. Ruled‑out diagnoses appear as (ruled out) in the compiled note while remaining excluded from the chart face and billing workflows.

Use this feature to track evolving clinical impressions over time and maintain compliance with coding and billing requirements.

Applies to

• Clinicians creating or editing notes in ICANotes+

When to Use Rule Out

Use Rule Out when you need to:

• Document a diagnosis under consideration but not yet confirmed

• Support treatment planning without impacting claims or billing

• Clearly distinguish suspected, confirmed, and ruled‑out conditions

How Rule Out Works

• A Rule Out (r/o) checkbox is available next to each diagnosis.

• When selected:

  • The diagnosis is removed from the active diagnosis list and chart face

  • The diagnosis appears as (ruled out) in the compiled note

  • The diagnosis does not appear on claims or billing‑related reports

  • The diagnosis carries forward to subsequent notes with the r/o status retained

• Clearing the checkbox restores the diagnosis to the active list.

Steps to Rule Out Diagnosis Code

Follow these steps to rule out a diagnosis from a note:

1. Open a client chart and create or edit a note.

2. Go to the Diagnosis section.

3. Locate the Rule Out (r/o) column next to the diagnosis list.

4. Select the Rule Out checkbox next to the diagnosis you want to rule out.

The diagnosis is removed from the active diagnosis list and marked as ruled out.

View Ruled-Out Diagnosis in the Compiled Note

When a diagnosis is ruled out, it appears on the compiled note with the (ruled out) label next to the diagnosis code.

Restore a Ruled‑Out Diagnosis

1. Open the Diagnosis section in the note.

2. Locate the ruled‑out diagnosis.

3. Clear the Rule Out (r/o) checkbox.

The diagnosis is restored to the active diagnosis list.

Important Notes

• Ruled‑out diagnoses:

  • Always remain visible in the Diagnosis modal

  • Override diagnosis status carryover rules

  • Do not appear on:

    • Claims

    • Billing Report

    • Denials Report

    • Productivity Report

FAQs 

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