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Thread: Comprehensive Exam/pain managmnt

  1. #1

    Unhappy Comprehensive Exam/pain managmnt

    AAPC: Back to School

    Does anyone have an idea of what constitutes a "Comprehensive Exam" for pain management specialty? Looking at '95 CMS guidelines a comprehensive exam=8 organ systems exam (why would a pain mgmnt Dr have to do all other systems not involved?) ....
    Marilyn CPC, CPC-H, CEMC

  2. #2
    Join Date
    Apr 2007


    I would probably lean more towards the single system exams of 97 guidelines, like neuro or muscleskeletal. Because I agree with you , why would they do that much? I had the same issue with a hand surgeon.

    Just my opinion.

    Laura, CPC

  3. #3


    Thanks Laura,

    The probelm I run into with that is that we use '95 guidelines and the '95 & '97 are not interchangeable on the same date of service....
    Marilyn CPC, CPC-H, CEMC

  4. #4
    Join Date
    Apr 2007
    Boston, MA


    I would use the 95 guidelines first, then also code by the 97 guidelines and use the one that has the better outcome for the physician. It is true, you have to chose one for the same case - mix-and-match is not allowed. But it is also stated that you have the right to use the guideline that works to the provider's advantage.
    Another thing to consider may be time. It is quite possible that the pain management provider spent a good amount of time education the patient about the various methods/options available in treating the specific pain. If the counseling takes more than half of the total time of the visit you can bill based on time - just make sure it is all clearly documented (total time, portion spent in discussion, details of conversation).

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