Wiki Details of 1995 DG Exam


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Is there information anywhere that clearly defines the difference between 'Affected body area or organ system...' (EPF) and 'Extended exam of affected area...' (DET) exams in the 1995 Guidelines?

...or does an auditor just decide on their own if what was documented is EXP or DET?

(I wish they would get rid of one of these sets of DG!!) :eek:

Check with your carrier

Check with your carrier.

SOME have decided to define them this way:
EPF = 2-4 body areas/organ systems
Detailed = 5-7 body areas/organ systems

OTHERS use the less well-defined:
EPF = Limited exam of affected body area/organ system, plus other related or affected systems
Detailed = Extended exam of affected body area ...(etc)

I usually look to see if there are at least five distinct comments / observations of the affected body area / organ system to count it as an "expanded" exam.

For example - chief complaint is ankle sprain
Limited exam: ankle is swollen and tender
Expanded exam: Left ankle swollen; no obvious bony deformity. Full sensation to touch, with lateral tenderness, and lateral bruising. No lacerations. Full range of motion but patient reports increased pain when flexed. On standing, patient cannot bear full weight without increased pain.
(Obviously, I am not an orthopaedic specialist. This is just off the top of my head from my own experience with a sprained ankle.)

Hope that helps.

F Tessa Bartels, CPC, CEMC
1995 DG FOR COSC examination- URGENT

In COSC AAPC study guide , they have mentioned like "......For most and for certification exam purposes ,it is the amount of information documented which determines the difference between epf versus detailed. If there are only brief statements, the exam would be considered epf. If there is ELABORATION OF FINDING FOR ATLEASET TWO OF THE AREAS AND\OR SYSTEMS then the exam would be detailed. "

When we go for COSC , do we follw this.
For example, if they are updating the pertinent system with elobaration, and 4 more system with limited examinations only means, what will be the Exam. Please advice on this.