tci ED Coding & Reimbursement Alert - 2002 Issue 9

Reader Question: Comprehensive Exams

Question: I'm looking for clarification of the exam portion of the 1995 E/M guidelines, which state that a comprehensive exam is comprised of eight or more organ systems. In terms of the abdomen and musculoskeletal organ systems, what differentiates the documentation required for a GI organ system from the abdomen body area? Also, how should I differentiate between the extremity body area and the musculoskeletal organ system? Oregon SubscriberAnswer: The requirement for a comprehensive exam is at least eight organ systems, or a complete exam of body areas, although this is not further delineated and was adopted more for...

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