decisionhealth Newsletters, Part B News - 1999 Issue 6 (June)
Comparison of 1995/1997 E/M Guidelines vs. E/M 'New Framework' Guidelines
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Article Overview
This article compares the 1995 and 1997 evaluation and management guideline structure with the American Medical Association CPT Panel’s later recommendations for a new framework. It is useful for coders, auditors, compliance staff, and clinicians who need a high-level view of how E/M documentation expectations are organized across versions and what kinds of history, exam, and medical decision-making topics are addressed.
Why This Topic Matters
E/M documentation requirements affect code selection, compliance review, and record completeness. Understanding how guideline frameworks differ helps readers evaluate charting expectations and prepare for changes in documentation policy.
Article Sections
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Comparison overview
Introduces the side-by-side comparison of multiple E/M guideline versions and frames the scope of the discussion.
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History
Summarizes the major history elements discussed across the guideline versions, including the general organization of history components.
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Review of systems (ROS)
Compares how review-of-systems requirements and levels are organized across the versions discussed in the article.
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Past/family/social history (PFSH)
Outlines the general treatment of past, family, and social history across the guideline sets.
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Elements (HPI, ROS, PFSH)
Describes how the history categories are combined and what general completeness concepts are referenced.
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Four types of history and criteria
Presents the overall history-level framework used to compare the guideline versions.
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Physical examination types
Reviews the broad categories used to describe physical examination structures in the guideline versions.
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Levels
Summarizes the level-based organization used in the physical examination comparison.
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Criteria for 4 types of physical examination
Compares the general criteria framework for physical examination levels across the versions.
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Medical decision-making
Outlines the medical decision-making framework and how complexity is structured in the comparison.
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Categories
Identifies the broad decision-making categories referenced by the article and compares how they are presented in each guideline version.
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Counseling and/or coordination of care
Summarizes the general time-based counseling and coordination-of-care guidance discussed in the comparison.
What You Will Learn
- How the article compares E/M guideline versions
- How history components are organized across guideline frameworks
- How review of systems and past/family/social history are categorized
- How physical examination and medical decision-making are structured in the comparison
- What general topics are addressed in time-based counseling and coordination guidance
Who Should Read This
- Medical coders
- Compliance staff
- Auditors
- Physicians and other clinicians
- Revenue cycle professionals
Code Ranges Discussed
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