Coding, Classification and Reimbursement

1995 E/M EXAM

  • 1.  1995 E/M EXAM

    Posted 13 days ago


    When auditing E/Ms based on the 1995 guidelines, can you choose from both the body area and the organ system as long as you do not double dip.

    EX: if I check off Respiratory and Neck

    If not allowed to utilize both during the same encounter, we focus primarily on the organ system, so where would thyroid fall under the organ system?

    Thank you,


    Brooke Mason
    Medical Billing and Coding Coordinator

  • 2.  RE: 1995 E/M EXAM

    Posted 6 days ago
    Hi Brooke,

    For your example, it only applies to the Problem Focused, Expanded Problem Focused, and Detailed Exam.  As for the Comprehensive Exam it has to be 8+ organ systems.

    Problem Focused = 1 BA/OS
    Expanded Problem Focused = 2-5 BA/OS
    Detailed = 6-7 BA/OS
    Comprehensive = 8+ OS

    Hope this helps.

    Shirley Bui
    Aurora Health Care Inc