Wiki PE needed for 99203..

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janellesmithcpc@gmail.com

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I've got a couple coding helps as far as the number of systems needed for the Physical Exam to code different levels for new or ret pt's, but I have conflicting data I guess.. I'm trying to figure out how many systems are needed to code 99203? I have a sheet that says 6 systems needed as well as 12 bullets. But another paper I have doesn't mention a # of systems, only the bullets..which says 6-11 bullets. Which is correct?? :/
 
Hi Janelle

I am assuming you are using 1997 Documentation guidelines, in order to get a detailed exam you need a total of 12 points. You can have 6 systems with two points each adding up to 12 points or you can have 12 points spread across many systems. Basically as long as you have 12 points within your exam is good. 6-11 points only allows for an EPF Exam not enough for a 99203. This is per CMS 1997 Documentation Guidelines which is what sets forth these standards.

Check out page 13.

"Detailed Examination – should include at least six organ systems or body areas. For each system/area selected, performance and documentation of at least two elements identified by a bullet (•) is expected. Alternatively, a detailed examination may include performance and documentation of at least twelve elements identified by a bullet (•) in two or more organ systems or body areas."

 
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