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Our office is in a program where the hospital codes some of the cases, and were are reimbursed by the hospital. They use the 95 rules. We were short a system for the comprehensive examination according to the hospital coders. They counted 7 systems. The doctor stated "no calf tenderness "under the extremities category. I asked why they could not count the calf tenderness under the muscskel system. They said that they could not because extremities is a body area. I was under the understanding that you could abstract the wording and use what is under this category for either the musckel system or the cardiovascular system (no edema, swelling) if their comments apply to that area, or it might even apply to the skin if they are discussing the warmth, lesions, etc. The doctors also stated no groin lymphadenopathy, and they would not give credit for the lymphatic system because it was listed under the extremities. I have always tried to look beyond the categories that the doctor quotes when coding with the 95 rules. I was wondering how others use the information that is under the extremity section to count the 95 requirements.
Thanks,
Dee
Thanks,
Dee