Wiki Exam - I need someone to break down


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Hi All,
I need someone to break down how I go about counting points for the exam portion of the three key components. How do we count points? I'm new to coding and I've gotten soooo much conflicting information on this.

No one seems to be able to tell me the difference between EPF and Detailed exam and so many different people add up points differently!!

HELP!! :confused: :eek:
I know there are some who audit and wouldn't allow a detailed or comprehensive exam if the notations were just "normal" or simple one word descriptions. The presenter at one seminar I attended said she wants detailed descriptions of their findings if she is going to credit a detailed exam and "normal" doesn't cut it. I think it was her way of figuring that they are meeting the medical necessity of the level. My providers are usually a bit more descriptive anyway.
That's the problem...what exactly sets apart the EPF exam and the Detailed exam? I'm not really sure how to go about adding up all the points of the exam's so confusing and like I said I've gotten conflicting information from different people...
If you use 1997 guidelines the difference is 6-11 bullets EPF, 12 or more Detailed.

So are you asking for what constitutes a bullet?

for example
3 vital signs=1 bullet BP 120/80 Pulse 70 Weight 143lbs
general appearance= 1 bullet 35 year old healthy appearing female
inspection skin=1 bullet No evidence of rash
palpation skin=1 bullet Skin warm and dry to touch

If the above is what you are needing get the 1997 guidelines up and they are all listed.

Laura, CPC
Or are you using 1995 guidelines

Even if you are using the 1995 guidelines to determine level of service, you might want to familiarize yourself with the 1997 bullet points. They are very clear and will help you learn to break down an exam dictation to identify the systems that are being covered.

If I understand your forum name correctly you are in Pediatric Cardiology. I work for Pediatric Surgery, so if you want to correspond with me ... I've sent you a private message with my contact info.

I'd be happy to try to help you understand E/M coding.

F Tessa Bartels, CPC, CPC-E/M