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1995 vs 1997 documentation guidelines

  1. Default 1995 vs 1997 documentation guidelines
    Medical Coding Books
    I am just starting a new position that includes some auditing. Can anyone give me some advice as to which guidelines are easier to use, 1995 or 1997?

  2. #2
    Hartford, CT
    When I audit I use both sets of guidelines. When reporting results you would use whichever is most advantageous to the provider.

    When I teach physicians I use the 1995 guidelines, they're more detailed and I think they provide better documentation, the 95 guidelines are vague as to what is actually required.
    Doreen Clark, CPC, CPMA
    Medical Auditing Specialist
    Integrated Physicians Management Services
    East Harftord. Ct

  3. #3
    Quote Originally Posted by dlentsch View Post
    I am just starting a new position that includes some auditing. Can anyone give me some advice as to which guidelines are easier to use, 1995 or 1997?
    We use the '95 guidelines which I feel is much more advantageous to our practice. The only time I may use the '97 guidelines is if I'm auditing a specific specialtly which would benefit more from the '97 guidelines.

    The only difference between the 2 guidelines is the physical exam. It is easier for most to attain a comprehensive exam using the '95 guidelines (e.g. 8 or more systems=comprehensive)

    Whereas with the '97 general multi-system exam comprehensive at least 18 bullets in 9 organ systems i.e. (Perform all elements identified by a bullet in at least nine organ systems or body areas and document at least two elements identified by a bullet from each of nine areas/systems.)

    We have neuro services which is when I may utilize the '97 guidelines because it's specialty specific; 22 bullets for comprehensive sytem specific.

    You may want to review the PE guidelines to see which works best for your practice.
    Last edited by Tonyj; 09-26-2014 at 07:44 AM.

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