Wiki Documentation for Preventive Exams

[dawn1170]

We are encountering providers who are mixing the '95 body area/organ system exam with the '97 “bullet” exam on preventive medicine visits. We have asked several sources if we can (and how) to give the providers credit for doing both and are getting inconsistent responses. What is your opinion on this and do you have sources you can refer us to clarify.

Thanks!

Dawn

 

[Lorisvg]

You must choose to use either the 95 or 97 guidelines (no mixing in the same encounter) You can choose which ever guidelines give you the best reimbursement on a case by case basis. There is a reference to this in the section of your CPT where the E/M section starts. (If you have AAPC's 2008 book, that is page 4 of E/M under the 1995 Federal Guideance heading).