Our 1995 audit tool allows us to count body area and/or organ system (i.e. you can mix them) for an EPF or detailed exam.
For comprehensive exam you must have 8 organ systems.
The 1995 guidelines just state that you need 2-7 body areas and/or organ systems for an EPF or detailed exam. Some have refined this to be 2-4 BA and/or OS for EPF; 5-7 for detailed.
debaloia states: To get a Detailed Exam we have to apply the 4 X4 rule which means 4 bullets in 4 different systems.
This sounds like a hybrid of the 1995 and 1997 guidelines to me. (Since 1995 doesn't have any "bullets," and 1997 would require 2 bullets from each of 6 areas/systems OR at least 12 bullets in 2 or more areas/systems.
Regardless, if your local carrier (Highmark or whoever) has specific guidelines then you'd be wise to follow them for that carrier.
F Tessa Bartels, CPC, CEMC
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join