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Thread: Can I count as a bullet

  1. #11
    Join Date
    Apr 2007


    AAPC: Back to School
    [*] Description of speech including: rate; volume; articulation; coherence; and spontaneity with notation of abnormalities (eg, perseveration, paucity of language)
    [*] Description of thought processes including: rate of thoughts; content of thoughts (eg, logical vs. illogical, tangential); abstract reasoning; and computation
    [*] Description of associations (eg, loose, tangential, circumstantial, intact)
    [*] Description of abnormal or psychotic thoughts including: hallucinations; delusions; preoccupation with violence; homicidal or suicidal ideation; and obsessions
    [*]Description of the patient’s judgment (eg, concerning everyday activities and social[*]situations) and insight (eg, concerning psychiatric condition)
    Complete mental status examination including
    Orientation to time, place and person
    • Recent and remote memory
    Attention span and concentration
    • Language (eg, naming objects, repeating phrases)
    • Fund of knowledge (eg, awareness of current events, past history, vocabulary)
    • Mood and affect (eg, depression, anxiety, agitation, hypomania, lability)

    "Alertness is a global observation of level of consciousness i.e. awareness of, and responsiveness to the environment, and this might be described as alert, clouded, drowsy, or stuporose"

    Concentration: act or process of concentrating, especially the fixing of close, undivided attention.

    Attention span: The length of time during which a person can concentrate on a subject or idea.

    How does the statement "Alert" tell us their ability to concentrate and the length of time they can pay attention to something?

    In all the auditing courses I have been too, both private and given by Medicare carriers, and the audits I have been thru A&Ox3 is 1 bullet under 97. Alert tells us they are conscious and that is not a bullet.

    Laura, CPC, CPMA, CEMC

  2. #12


    The statement saying that patient is alert, itself means that he is in a state of paying close and continuous attention. This itself is the focus of mental status examination in all the verbal and nonverbal exercises or tests that are done to test the cognition under the bullet "Attention span and concentration".
    Jagadish, CCS-P, CPC

  3. #13
    Join Date
    Apr 2007

    Default Agree to disagree I guess

    I wish you all the best in counting that. I am speaking from my experience working with auditors employed by the OIG and various consultants in the field.

    When using 97 guidelines they do not count the "A&O" at all unless it is "A&Ox (1, 2, or 3)", then it is 1 bullet.

    Laura, CPC, CPMA, CEMC

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