I'm auditing a general surgery practice and was told they follow 97 guidleines, but they do have a podiatrist that only does body area exam and that is more of a 95 General Body exam. Does a practice have to follow the same chosen guidelines or can it be per provider? Thanks.
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Wiki 95/97 Guidelines
- Thread starter jvaughn5
- Start date
RebeccaWoodward*
True Blue
The provider has the option of both unless the practice has a policy in place requiring a particular set.
Documentation Guidelines for E/M Services - Carriers and A/B Medicare Administration Contractors (MACs) are to continue reviews using both the 1995 and 1997 Documentation Guidelines for Evaluation and Management Services (whichever is more advantageous to the physician).
•1995 Documentation Guidelines for Evaluation and Management Services
•1997 Documentation Guidelines for Evaluation and Management Services
https://www.cms.gov/MLNEdWebGuide/25_EMDOC.asp
Documentation Guidelines for E/M Services - Carriers and A/B Medicare Administration Contractors (MACs) are to continue reviews using both the 1995 and 1997 Documentation Guidelines for Evaluation and Management Services (whichever is more advantageous to the physician).
•1995 Documentation Guidelines for Evaluation and Management Services
•1997 Documentation Guidelines for Evaluation and Management Services
https://www.cms.gov/MLNEdWebGuide/25_EMDOC.asp