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Thread: 95/97 Guidelines

  1. #1
    Join Date
    Apr 2007

    Default 95/97 Guidelines

    AAPC: Back to School
    I'm auditing a general surgery practice and was told they follow 97 guidleines, but they do have a podiatrist that only does body area exam and that is more of a 95 General Body exam. Does a practice have to follow the same chosen guidelines or can it be per provider? Thanks.

  2. #2
    Join Date
    Apr 2007
    North Carolina


    The provider has the option of both unless the practice has a policy in place requiring a particular set.

    Documentation Guidelines for E/M Services - Carriers and A/B Medicare Administration Contractors (MACs) are to continue reviews using both the 1995 and 1997 Documentation Guidelines for Evaluation and Management Services (whichever is more advantageous to the physician).

    •1995 Documentation Guidelines for Evaluation and Management Services
    •1997 Documentation Guidelines for Evaluation and Management Services


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