AMA CPT® Assistant - 1998 Issue 1 (January)
Documentation Guidelines Update (January 1998)
January 1998 pages 1-4 Documentation Guidelines Update The Health Care Financing Administration has confirmed, in a letter dated December 5, 1997, that the current "grace period" for enforcement of the Documentation Guidelines, has been extended until July 1, 1998. [See later information about the "grace period."] The American Medical Association requested an extension of the grace period to allow for additional education about the use of the guidelines. HCFA will delay requiring the use of the new guidelines as the only standard for E/M until July 1, 1998. Random prepayment review of claims began in October, 1997 and...
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Article Overview
This article explains a temporary extension affecting documentation guideline enforcement and presents updated multi-system and skin examination tables used in evaluation and management documentation. It is relevant to physicians, coders, auditors, and compliance staff who need to understand how the guidance was being applied during the transition period.
Why This Topic Matters
The article helps readers track a time-sensitive policy update and review the documentation standards that support evaluation and management level selection.
Article Sections
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January 1998 pages 1-4
Introduces the update and notes that the issue includes reprinted tables and related documentation guidance material.
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Documentation Guidelines Update
Summarizes the enforcement timeline update and the transition period for using documentation guidelines.
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Table 2-General Multi-System Examination
Presents a reference table of examination elements organized by body system for multi-system evaluation and management documentation.
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Content and Documentation Requirements
Outlines documentation thresholds associated with levels of multi-system examination.
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Table 12-Skin Examination
Provides a reference table focused on skin examination elements and related body areas used in documentation.
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Content and Documentation Requirements
Summarizes documentation thresholds associated with levels of skin examination.
What You Will Learn
- How the article frames the documentation guideline update and grace-period extension
- Which examination categories are covered in the reprinted tables
- How the article organizes documentation requirements by level for different exam types
- What broad documentation topics are included for evaluation and management review
Who Should Read This
- Physicians
- Medical coders
- Clinical documentation staff
- Compliance professionals
- Auditors
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