# E/M for Dermatology practice



## cchilva (May 10, 2009)

I was wondering if anyone could point me in the direction of obtaining an E/M grid or pocket reference specifically for a derm practice. 

Another question I have is has anyone heard of not obtaining a patients vitals in a derm office? I'm at a loss, I have never worked in a physicians office where the vital signs were not taken. Isn't this part of the elements of the exam? How would this be looked at from an auditors perspective?

I appreciate any input on this.

Cindy Chilva, CPC


----------



## FTessaBartels (May 11, 2009)

*1997 Guidelines*

Cindy,
Google "1997 E/M guidelines" and you'll find several sites that have this information. There is a specialty exam for "SKIN" under the 1997 guidelines that you may find helpful. 

As for vitals ... that is only ONE bullet point of many that may count toward determining the level of exam (and ultimately level of E/M service). 
For a problem focused exam you need ONE-five bullet points, and you can achieve that without taking so much as one vital sign.

However if you want to bill a CPT code that requires a *comprehensive* exam, and you are using the Skin Specialty guidelines you *MUST *have at least 3 vital signs. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


----------

