Wiki E & M exam element guidelines


True Blue
Hinsdale, MA
Best answers
Have any of you heard that in July 1, 2017 exam elements are changing from 2-7 elements for Expanded problem-focused and Detailed,
or 2-4 elements for Expanded problem-focused and 5-7 for detailed to:
2-5 elements for expanded problem focused and 6-7 for detailed?
That means exam level may change from 4 to 3 if only 5 elements are used
By elements I mean a body/organ system with at least 2 points per area on body.
According to Medicare, now at least 6 body/organ systems will be necessary for a level 4 (detailed) exam
Is this right?
Are there any updated E and M audit worksheets out there to reflect new exam requirements?
This is from a bulletin from NGS Medicare contractor only if you are choosing to follow the '95 exam guidelines.

As far as I know it's not a universal CMS policy, and it's been clarified for just 2 types of exams.

Here is the bulletin.

Again, so far this is just NGS (National Government Service)'s policy. It doesn't reflect change in policy or requirements from other CMS contractors or commercial carriers.