# scoring the ROS



## obrien44 (Jun 25, 2010)

I am having difficulty coding the level of history for established patients.

When using the Medicare E/M Score sheet what is the difference between problem focused and expanded problem focused ROS in an ophthalmology exam?

For example; the patient comes to the office for an IOP check without any complaints.  Would you score EPF; pertinent to problem – 1 system (eyes) or would you say Problem Focused; none.

We only score problem focused if the doctor did not sign our ROS form that the patient completes.  

Established patient w/o any complaints:

History: Problem focused
Exam: Comprehensive
MDM: Straightforward
CPT Code: 99212

	Or 

History: Problem Expanded
Exam: Comprehensive
MDM: Straightforward
CPT Code: 99213

	Or

Does the History not matter and you choose the CPT Code based on the MDM – and it would be 99212?


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