Wiki 97 General Multi-System

[bkvanausdal]

Question, there is a debate that I've been hearing with the 97 Multi-System Guidelines. To get a Comprehensive Exam you need 2 elements identified by a bullet from each of nine areas/system, right? On the Lymphatic exam there is one bullet (palpitation) with four "sub-bullets" Neck, Groin, Axillae and Other. From one point of view it is viewed as only one element available from the lymphatic area, whereas others view it as four opportunities for elements. Aka, if Lymphatic has Neck and Axillae selected and 8 other areas have two elements selected does that give a comprehensive exam or can Lymphatic only be counted as 1 element thereby making it detailed instead of comprehensive?

If you have an actual source (CMS or other) please include!!!

THANK YOU!!

 

[bmcfarland]

There is a good table in the Medicare Physician Guide at cms.gov titled Content & Documentation Requirements (starts around pg 13, I think) that specifies that in order to get credit for the Lymphatic System in a general multi-system exam, lymph nodes need to be palpated in two or more areas (neck, groin, axillae, other) so you need to account for at least two of your "sub-bullets" in order to get credit for one element but palpation of all four areas still only counts as one element.