95 vs 97

[mtimson]

For 1995 &/or 1997 guidelines in our office, do we have to pick one in particular and always use, or can we use whichever one fits the dx?

Thanks for any help!
~Marty

[mhstrauss]

The provider is allowed to choose whichever is most beneficial to him/her for that particular encounter. They can switch back and forth from patient to patient, just can't switch within the same document.

Hope that helps!

[llharg]

It is my understanding they cannot change with each encounter. There should be a compliance manual for the office and whichever guidelines they have in their compliance manual is the one they must abide by. I would look into this further. Keep in mind that the 97 guidelines were more geared toward specialities and I'm assuming if the clinic is not a specialty type, they probably chose the 95 guidelines as that is much easier. This is my take on it.

[LRKoschoreck]

Meagan is correct. You can use whichever set of guidelines benefit the provider for that encounter, but you cannot mix 1995 and 1997 within the same encounter.

Check out page 13 of the Evaluation and Management Services Guide