decisionhealth Newsletters, Part B News - 2014 Issue 5 (May)
Side-by-side comparison of 95, 97 E/M guidelines for exam
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Article Overview
This article compares the 1995 and 1997 E/M exam guidelines used in documentation review. It is aimed at coders, auditors, and clinicians who need a quick way to understand how the two guideline sets are organized and what types of exam elements they emphasize.
Why This Topic Matters
Understanding the differences between the 1995 and 1997 E/M exam frameworks helps support consistent documentation review and selection of the appropriate guideline set for claims.
Article Sections
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Organ systems and body areas
Lists the exam structures used under each guideline set, including the general categories of organ systems and body areas referenced by the comparison chart.
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Exam
Compares the exam level framework across the two guideline sets, showing the broad categories of examination intensity used in documentation review.
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Note
Provides a brief clarification about the 1997 guideline presentation and points readers to a related cardiology example.
What You Will Learn
- How the 1995 and 1997 E/M exam frameworks are organized
- Which broad exam categories are compared between the two guideline sets
- What types of documentation elements are emphasized in the comparison chart
- How the article frames the use of the chart for documentation review
Who Should Read This
- Medical coders
- Coding auditors
- Physician practices
- Compliance staff
- Clinical documentation staff
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