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95 exam guideline question

  1. #1
    Default 95 exam guideline question
    Exam Training Packages
    Its my understanding that the 95 Guidelines for the exam have been changed from EPF 2-7 body areas and/or organ systems to 2-5. Also detailed from 2-7 to 6-7. Can someone please tell me when and if this change occurred. We currently use 97 guidelines but I need confirmation on this.

  2. #2
    Location
    Kansas City, MO
    Posts
    431
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    No, this is incorrect. There are NO number guidelines given in the 95 guidelines at all. These "number of system/area guides" are industry created guidelines that are based on the guidelines.

    You can probably safely infer that PF is one system, and EPF atleast two....but other than that you can't know for sure.

    Some local MAC's have adopted their own set of guidelines and have published them...but again, if you look at the actual guidelines you will not find any of the 2-4, 5-7 type rules.
    Linda Vargas, CPC, CPCO, CPMA, CPC-I, CEMC,CCC
    PMCC Licensed Instructor
    Kansas City, MO Chapter
    President, 2018
    Vice President, 2017
    Member Development Officer 2016
    Harrisonville, MO Chapter President - 2013
    ICD-10 Education Coordinator- 2012
    Chapter President - 2011
    President Elect - 2010

  3. #3
    Location
    Evansville Indiana
    Posts
    451
    Default Ngs
    NGS has put out the guidance that their auditors will be using the 2-5 EPF 6-7 detailed for exams. They had an audioconference not long ago and went over this information. If they are your carrier you can go to their website to obtain this information.
    LeeAnn

  4. #4
    Post
    We have been using these 2-4, 5-7 - 95 guidelines for a long time and have no issues with billing.
    Girish Dadhich, CPC

  5. #5
    Default
    That is also what we have been asked to do here as well (2-4 & 5-7). My supervisor and myself were told by one of our outside auditors that this will be the new focus for them in the future. I have yet to see anything in writing regarding this, but that is what I am going by right now.

  6. #6
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    Thank you for the info - NGS is our carrier

  7. #7
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by CBC View Post
    Its my understanding that the 95 Guidelines for the exam have been changed from EPF 2-7 body areas and/or organ systems to 2-5. Also detailed from 2-7 to 6-7. Can someone please tell me when and if this change occurred. We currently use 97 guidelines but I need confirmation on this.
    Also...check with your carrier if they allow the combination of organ systems and body areas for 95's. Our new carrier, Palmetto GBA, does not allow this. I'm still scratching my head about it but it is published on their website.

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