# Multi-system exam rules - please help!



## btadlock1 (Apr 4, 2011)

Under 1997 guidelines, as most of you know, there are the single-OS exams, and the general multi-system exam. All of the guidance I've been able to find says that the single OS exams were designed for specialists, but that anyone can use them. What I *can't *seem to find, is whether you can use bullet criteria from a Single OS exam with the Multi-system exam...
Some of the bullets that I think my providers are going for aren't on the multi-system exam, but they *are *scattered throughout the single OS bullets. How does that work? Can I mix and match with the multi-system exam, or is it strictly "what you see is what you get", with the bullets available?

For example: I've got the phrase "Speech clear and coherent. Functional cognition intact."
Under the Single OS Psychiatric exam, that's worth 2 bullets - Description of speech, and description of thought processes. Those bullets don't exist under the Multi-system exam. Can I still count them???


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## btadlock1 (Apr 5, 2011)

*Seriously???*

Nobody knows??? I need help! Please!


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## FTessaBartels (Apr 8, 2011)

*NO, you cannot mix*

No, Brandi, you cannot mix the bullets for specialty exams with the bullets for the general multi-system exam. 

Why?  The expanded bullets for the single speciatly exams were created specifically to give those specialists who never (or very rarely) perform an exam much beyond the affected area/system a way to still achieve a comprehensive exam.  You *do not *have to be a specialist in that field to use the single specialty exam, but you cannot mix bullets from the single specialty exam with bullets from the general multi-system exam to achieve the required number of bullets. 

As an auditor, you can tally the bullets / requirements using 1995, 1997 general, and 1997 specialty guidelines, and then assign the highest one met for *THAT NOTE*. So it might be best to use 1995 for note # 1, 1997 musculoskeletal specialty for note # 2, and 1997 general multi-purpose exam for note # 3. Perfectly acceptable. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## btadlock1 (Apr 8, 2011)

FTessaBartels said:


> No, Brandi, you cannot mix the bullets for specialty exams with the bullets for the general multi-system exam.
> 
> Why?  The expanded bullets for the single speciatly exams were created specifically to give those specialists who never (or very rarely) perform an exam much beyond the affected area/system a way to still achieve a comprehensive exam.  You *do not *have to be a specialist in that field to use the single specialty exam, but you cannot mix bullets from the single specialty exam with bullets from the general multi-system exam to achieve the required number of bullets.
> 
> ...



You are wonderful! Thank you!


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