# E/M Physical Exam-Constitutional requirements



## Diana2032 (May 17, 2016)

I’m new to E/M coding and my coworker is telling me that when it comes to the Constitutional Exam NOT only the *three vital signs *are required but also and evaluation of the patient’s  *physical appearance* (E.g. development, nutrition, body habitus, deformities, attention to grooming, etc). I have been told in the past that it was either or not both. Can someone clarify this for me? Are both required vitals and physical appearance? 

Thanks so much!!!


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## smidge1 (May 17, 2016)

*E/M Constitutional*

The E/M guidelines do not state that you have to have both; you need to have 3 in that category to meet
the E/M guidelines.

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNEdWebGuide/EMDOC.html

Here is the link to the CMS website for the coding guildelines.

Hope this helps


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