tci Part B Insider - 2004 Issue 19

E/M Coding: When It Comes To ROS And HPI, The Carrier's Whim Rules Your Fate

If you're trying to reach the requirement of 10 organ systems in the Review of Systems for evaluation and management coding , can you use information that was also recorded in the History of Present Illness?   Yes, according to the American College of Emergency Physicians. ACEP has on its Web site correspondence from CMS that, while somewhat ambiguous and not binding, seems to support this interpretation. But when the rubber hits the road, "the real answer is, it depends what the carrier says," says David McKenzie, ACEP director of reimbursement. And the carriers provide not just contradictory, but...

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