Wiki 95 verses 97 Exam

[lrott]

HELP PLEASE - I know that either the 95 or 97 quidelines can be used and normally you want to use the one that is better for the provider. If you choose to use the 95 because it will drive the level of service higher for the provider but the provider documents under cranial nerves "hearing intact bilaterally" (even though we aren't using the 97) this should be counted under ENMT correct? I'm not trying to chop up the cranial nerve portion but again I'm going to use the 95 organ system instead of the 97 Neurological Exam. Any direction on this would be greatly appreciated. Thank you for your time..

 

[OCD_coder]

Use whichever guideline benefits the provider for the date of service. You are correct that hearing intact bilaterally would be credited toward ENT organ system for the '95 DG.

 

[Tonyj]

HELP PLEASE - I know that either the 95 or 97 quidelines can be used and normally you want to use the one that is better for the provider. If you choose to use the 95 because it will drive the level of service higher for the provider but the provider documents under cranial nerves "hearing intact bilaterally" (even though we aren't using the 97) this should be counted under ENMT correct? I'm not trying to chop up the cranial nerve portion but again I'm going to use the 95 organ system instead of the 97 Neurological Exam. Any direction on this would be greatly appreciated. Thank you for your time..

Under '95 OS guidelines it's ENMT. Your documents states "hearing intact bilaterally". Without mention of nose, mouth and throat I wouldn't give credit for it.

 

[OCD_coder]

ENT is a single organ system and there is no requirement that all three body areas (ears, nose and throat) are required to be examined for credit to the provider.

Please share any source backing up your statement.