Wiki orthopedic e&m help

[Ash82]

I am having trouble when it comes to the exam part of E&M. When the physician is telling me the different tests he performed on the patient, McMurrays, Spurlings, Lachmans, etc.... how do each of these tests correlate to the exam? When counting up "bullets", I'm not quite sure how to use those tests. Does anyone know of any type of "cheat sheets" or anything to help with this? Help would be most appreciated!!!

 

[codeon]

You can look up the 1995 and 1997 E/M documentation guidelines. You can also use the E/M audit tool. Tests and procedures that were done count in the medical decision making.

 

[jdibble]

I am having trouble when it comes to the exam part of E&M. When the physician is telling me the different tests he performed on the patient, McMurrays, Spurlings, Lachmans, etc.... how do each of these tests correlate to the exam? When counting up "bullets", I'm not quite sure how to use those tests. Does anyone know of any type of "cheat sheets" or anything to help with this? Help would be most appreciated!!!

Are you using the 95 or 97 guidelines? If you are using 95 guidelines, these tests would all fall under musculoskeletal. If you are using the 97 guidelines, (which I am assuming since you are counting "bullets") using the musculoskeletal specialty exam score sheet, you would just count the bullets for each body part that these tests were performed. For example, if the doctor is performing a McMurray and Lachmans test on the patient's knees, then you would use the Musculoskeletal "chart" to count the bullets for each element covered. The doctor must document his findings, not that he just performed those tests.

Tests and procedures that were done count in the medical decision making. Codeon

These are not tests that would be considered in the MDM.

Hope that helps.

 

[Ash82]

I understand what you all are saying and I use the musculoskeletal specialty exam. What I am having trouble with is understanding the tests. For example, when they do a McMurrays, does it hit the bullet for assessment of range of motion or stability or muscle strength, or does it hit one of the neurological like exam of deep tendon reflexes or exam of sensation? I don't understand these tests enough to know exactly what they are doing and how each correlates to the specialty exam. I was wondering if anyone knew of a cheat sheet or something like that for different tests done in an orthopedic office.

 

[mhstrauss]

I understand what you all are saying and I use the musculoskeletal specialty exam. What I am having trouble with is understanding the tests. For example, when they do a McMurrays, does it hit the bullet for assessment of range of motion or stability or muscle strength, or does it hit one of the neurological like exam of deep tendon reflexes or exam of sensation? I don't understand these tests enough to know exactly what they are doing and how each correlates to the specialty exam. I was wondering if anyone knew of a cheat sheet or something like that for different tests done in an orthopedic office.

I use http://www.neuroexam.com/neuroexam/ for the neuro components of the exam. I haven't come across anything like this for musculoskeletal...if I do, I will post here.

 

[Ash82]

Thanks so much mhstrauss! I appreciate any help I can get.

 

[Camleiben]

I used to have a cheat sheet for this issue, but can't find it, but I made it by Googling each exam name, which usually brought up enough info to figure it out. I can tell you that a lot of them are for stability.

Also, if you have access to a helpful nurse or physician, ask them. When I started working with Ophthamology, I got one of the MDs to give me a crash course in terminology and it was super helpful.