# Caveat and Exam????



## vanessa10 (Apr 28, 2010)

If the pt is critical/unresponsive and there is not enough time for critical care I would use the caveat. But does it apply to the exam? I never thought it did, but I have something here from the American College of Emergency Physicians saying it does right at the end of the description of the caveat...

"The level 5 caveat- the definition of 99285 includes the concept that the History, Exam, and MDM requirements must be met "within the constraints impose the urgency of the pt's clinical condition and/or mental status". Most Medicare carriers require a description of the pt's urgent condition and the physician's thought process. So make sure to document why the severity of your pts illness precludes performing a full History or EXAM."


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## sparkles1077 (Apr 29, 2010)

See ACEP website.  The caveat does not include the exam.  The physician can still perform a physical exam because they can physically see and examine the patient.  The history is difficult because the patient is not in the condition to answer the questions.


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## vanessa10 (Apr 29, 2010)

I completely agree, but i did quote the acep website where it included exam in the level 5 caveat. maybe they missed this and it is incorrect information


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## sparkles1077 (Apr 29, 2010)

Yes, I see where they are getting this.  Sorry, I did so much reading on CC for my own stuff, I must have read this somewhere else.  I'll look for it tomorrow and let you know the resource.

Diana


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