E/M level question

sherrieneidigh

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Question: Is the criteria for level of visit for E/M coding the same for a single specialty like a gastroenterologist versus a general visit? For example does an office visit for a gatroenterologist have to document 12 to 17 bullets from 5 to 7 systems on the physical exam, in order to meet the detailed level?
 
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No 1997 GI Specialty Exam Guidelines

You wrote:
For example does an office visit for a gatroenterologist have to document 12 to 17 bullets from 5 to 7 systems on the physical exam, in order to meet the detailed level?

There are no 1997 GI Specialty Exam Guidelines to follow, so you must use the General Multi-System Exam guidelines.

For a detailed exam under 1997 guidelines, you need to document at least 2 elements from each of 6 areas/systems -or- at least 12 elements in 2 or more areas/systems.

For a comprehensive exam under 1995 guidelines, you need to document a detailed examination of the problem area/system, and examination of at least one other related system. (This per the actual wording of the guidelines.) Some carriers follow the guideline that you need to document examination of 5-7 body areas/organ systems; others use 6-7 body areas/organ systems.

I am not familiar with any guidelines requiring "12 to 17 bullets from 5 to 7 systems"

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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