# TrailBlazer vs Medicare Audit Tool



## jifnif (Sep 16, 2009)

I have a print out of an audit tool that Medicare uses and I have one from the TrailBlazer website, they are different in the respect that in History on the TrailBlazer copy you need to meet criteria for HPI and ROS for all levels except ROS in Problem Focused and PFSH in EPF.  On Medicare's you don't need any criteria in HPI for PF or Detailed and PFSH for EPF.  OR  Am I reading Medicare's tables wrong and the blanks mean "Brief"?  Thanks for your help.


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## LLovett (Sep 16, 2009)

I'm not sure what form you are looking at, could you post the link to the CMS tool?

Based on 95/97 guidelines the tool should require the HPI be brief for PF and EPF, the ROS is N/A for PF and problem pertinent for EPF, and the PFSH is not required for either PF or EPF.

Laura, CPC, CEMC


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## jifnif (Sep 16, 2009)

*From Highmark Website*

http://www.highmarkmedicareservices.com/partb/reference/pdf/scoresheets/8985.pdf


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