E & M Documentation Guidelines
Code Component
1995 Requirements
1997 Requirements
Draft Guidelines (June 2000)
The Good News-- What’s Different
Hx - History of
Present Illness
Specific requirements
Specific requirements
·Clearer requirements
· Explicit recognition of medication monitoring
Hx - Review of Systems
Specific body area or organ system
requirements
Specific body area or organ system requirements
·Less required
· Clearer
· Examples are provided
Hx - Past, Family,
Social History
Brief information required
Brief information required
No difference
Physical Exam
·Specifically referenced general multisystem exam
· Description of single system exams inadequate
· 4 levels
· Requirements not clear
·General multi-system exam and 10 single system exams
· 4 levels
· Very prescriptive
· Confusing shading & bullets format
· Requirements often not relevant
·Physician tailors documentation to exam
· Only 3 levels
· Vignette examples
· No bullets
· No shading
· Minimal counting
· No irrelevant facts to record
Medical Decision
Making
·4 levels
· laundry list of examples not reflective
of clinical assessments & plans
·4 levels
· Laundry list of examples not
reflective of clinical assessments &
plans
·Only 3 levels
· Physician tailors documentation to
assessment & plan of treatment
· Vignette examples