I have not taken the CPMA exam but just make sure you do not use anything in you HPI for both the HPI and ROS....you can't double dip. Yes you will need to take your ROS from your HPI if needed. In this case you would have the ENT for the ROS for "denies any postnasal drip or fullness in her ears when she swallows"
Example...you have a complete HPI/ PFSH and the ROS that has 9 elements (new patient). If the entire chart justifies a level 99205 but you have have 9 elements in your ROS you would pull the ENT from your HPI to have a detailed ROS that would then give you a 99205. If that would not have been caught and pulled from the HPI you would have billed a 99204.
My suggestion is to see if you can't locate E&M scenarios.
Hope this helps!
Renae CCS, CPC
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