I'm sorry, but I don't fully understand your question.
The 1997 guidelines allow you to follow EITHER the General Multi-system Exam -OR- one of the specialty exams.
If you are following a specialty exam for Musculoskeletal (there is no "ORTHO exam") then the guidelines specify how many bullets you need for each level of exam.
The bullets are listed by system and some systems are shaded.
Problem focused exam = 1-5 bullets
EPF exam = at least 6 bullets
Detailed exam = at least 12 bullets
Comprehensive exam = Perform ALL elements identified by a bullet / and document EVERY element in each shaded box, and at least ONE bullet from each unshaded box. (By the way, there are only two unshaded boxes and they only have one element each.)
If you are following the General Multi-System exam there are NO shaded boxes.
Problem focused = 1-5 bullets
EPF = at least 6 bullets
Detailed = at least 2 elements from each of 6 areas/systems -OR- at least 12 bullets from two or more systems. (in both cases you need at least 12 bullets)
Comprehensive = at least 2 bullets from each of nine areas/systems (i.e. at least 18 bullets, but you must have covered at least 9 areas/systems)
I highly recommend www.emuniversity.com for help in understanding E/M auditing and coding.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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