I am a little confused on the 95 exam. If you have one body area (neck) and one organ system would this count as a problem focused exam or would you count the body area and the organ system as a expanded focus exam ? I have read guidelines that say body area and/or organ system. Does it have to be body areas OR organ systems and not a combination of both as long as you don't choose for example abdomen and Gi . HELP!
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Wiki 95 Exam
- Thread starter HOWRU2DAY
- Start date
Pam Warren
True Blue
You may want to check with your local contractor. Ours (NHIC) on the 7/6/2010 version of the E&M Coding worksheet indicates the following:
1 BA or OS = PF
2-4 OS and/or BA = EPF
5-7 OS and/or BA = Detailed
8 (or more) OS = Comprehensive.
As you can see, not all contractors follow the 95 guidelines in the same way.
To answer your question, with one BA and one OS, (if pertinent to the chief complaint), it would meet EPF.
1 BA or OS = PF
2-4 OS and/or BA = EPF
5-7 OS and/or BA = Detailed
8 (or more) OS = Comprehensive.
As you can see, not all contractors follow the 95 guidelines in the same way.
To answer your question, with one BA and one OS, (if pertinent to the chief complaint), it would meet EPF.