Gastroenterology Coding Alert

Coders have to count systems constantly in order to ensure the proper review of systems (ROS) level.

Use this list to identify the 14 systems as described in CPT 2010. Keep it handy just in case you need a quick reference:

According to CPT 2010, "the following elements of a system review have been identified:

• constitutional symptoms [fever, weight loss, etc.]

• eyes

• ears, nose, mouth, throat

• cardiovascular

• respiratory

• gastrointestinal

• genitourinary

• musculoskeletal

• integumentary [skin and/or breast]

• neurological

• psychiatric

• endocrine

• hematologic/lymphatic

• allergic/immunologic."

Best bet: When counting ROS, be sure to include each review question under one of these categories.

Also, if you have a CPT stickler for a payer, check its ROS requirements before coding.

"Per CPT nomenclature, a complete ROS would necessitate a review of all additional body systems. This would include 14 systems. However, the CMS Documentation Guidelines define a complete ROS as covering at least 10 organ systems," explains Kenny Engel, CPC, coding coordinator with Advanced Healthcare in Germantown, Wis.

Most payers are not so strict, however, and will consider the review a complete ROS after the physician reviews 10 systems. This falls in line with Medicare's 1995 and 1997 Documentation Guidelines.