# Need help with Comprehensive Exam for musculoskeletal



## mcarrillo (Mar 19, 2012)

Hi,

Can someone explain to me the requirements for a comprehensive exam for the musculoskeletal system ('97 guidelines) ? From what I understand, it means all elements from the shaded and non-shaded borders with bullets. The non-shaded without bullets, such as head and face, eyes, ENMT... don't count towards any of the exams...right?
Thanks for any help.

Maria


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## FTessaBartels (Mar 19, 2012)

*1997 Comprehensive Musculoskeletal Exam*

You must perform ALL items in the shaded boxes.
*And*
You must perform at least ONE item in each of the UNSHADED boxes.  Of course there are only Two UNSHADED boxes with any bullet points ... and they each have only one each (Cardiovascular - exam of peripheral vascular system by observation and palpation / Lymphatic - Palpation of lymph nodes in neck, axillae, groin and/or other location), so basically you have to perform everything listed with a bullet point.

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## mcarrillo (Mar 21, 2012)

Thank you F Tessa. This is a big help. I do have another question though if you can answer for me.
For the musculoskeletal bullets where it states '*four of the following six* areas:...', the doc MUST do four of them to get the bullets? 

I  have a doc who did all the elements in the bullets in the musculoskeletal area, but only for a knee and a hip. Would he still get the elements?

Thanks
Maria


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## FTessaBartels (Mar 30, 2012)

*Four of the following Six areas*

No, in the 1997 guidelines, he would not get ANY bullet for performing the exam only on knee and hip.  He must examine at least 4 of the areas to get ONE bullet in order to get any credit for a comprehensive exam. 

Let's say he does this bilaterally ... checking both the right and left hip joint and right and left knees.  He still has covered only THREE areas (pelvis, right LE and left LE).  

Please NOTE, for a lower level exam he can count the bullet for each body area

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## FTessaBartels (Mar 30, 2012)

*One more thing*

You may also have enough bullets using the 1997 General Multi-System Exam guidelines to qualify for a comprehensive exam.  Just because he's an orthopedic surgeon does not mean you HAVE to use the Musculoskeletal Exam guidelines. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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