1995 exam guideline question

Do you have anything from CMS regarding the 1995 auditing guidelines which state how to determine whether an organ system exam is a limited or extended exam? I have been using the number of bullets that count on the 1997 guidelines as an extended (i.e. Cardio: 3 three or more items examined give an extended.)

My office is telling me to disregard the limited extended differences and just count 1 point if the provider mentions it in the documentation. So for instance:
HEENT-unremarkable, (they are giving two organ systems) Eyes and ENT? Do you agree
Is that the intent?

95

There are many auditing tools for both 95 and 97 guidelines. The one I have is from Florida Medicare and it has athe exam portion as follows:
PF exam=1 organ system/body area
EPF=2-7 organ systems/body areas
Detailed= 2-7 organ systems/body areas in more depth
Comprehensive= General multi-system exam of 8 or more systems or complete exam of a single system*

*95 comprehensive exam must be 8 or more organss systems; cannot combine systems with body areas. All lower level exams can combine organ systems and body areas

1995 exam

There is an article on this topic, entitled, Auditing the 1995 exam.

Search for it in the database.

CMS itself has never clarified the difference between the EPF and detailed exam. Some carriers use 2-4 or 5-7 body parts or organ systems. I, personally, don't.

The article provides more details.