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help with levels on PE

  1. #1
    Default help with levels on PE
    Medical Coding Books
    Need other's opinions.

    For examination, exp. problem focused and detailed exam state "up to 7 systems". How do you determine which level to code on the examination if for example you have 4 systems reviewed? Is there documentation out there that breaks down the criteria more than "up to 7 systems"?

    Thanks for any help.

  2. #2
    Columbia, MO
    What are you looking at? If you are using the 97 guidelines it specifies under each body system the number of bullets for a level of exam. I have not read anything that matches what you are saying.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Thanks for your help. I have confused myself. lol. I was looking at an audit sheet.

    Thanks again.

  4. #4
    There is no clear cut definition of 95 exam guidelines.

    Some MACs do define them, those are nice, the ones that publish their audit sheets usually do define the difference between EPF and Det.

    For those that don', like WPS, it is up to your facility/office to define what you are going to follow.

    One of the most common splits is 2-4 EPF, 5-7 Det. This is what we follow where I am.

    Hope that helps,

    Laura, CPC, CPMA, CEMC

  5. #5
    Ellenville, New York
    We do the same as Laura - 2 to 5 systems/body areas would be EPF, 6-7 would be detailed, when using the 1995 guidelines. Our MAC (NGS) isn't so kind as to set clear guidelines.

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