How much credit would you give if MD writes PERLA using Novitas 4x4 rule for a detailed exam? Thanks


  • edited June 2017
    Of all the dumb things that payers have come up with the 4x4 rule has to be near the top of the list. You have to document 16 findings for a detailed exam but only 8 for a comprehensive.

    But I digress, so if you need 4 elements in 4 systems I would count PERRLA as 4 elements. It means the:
    Pupils are Equal
    Pupils are Round
    Pupils are Reactive to Light
    Pupils are Reactive to Accommodation


    Todd Thomas, CPC, CCS-P ERcoder, Inc
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  • Agree Todd, with the 4x4 you can have a more extensive exam than a comprehensive.

    LuAnn Weis, MPA, CHC, COC, CPC, CPCO, CPMA
    Director of Compliance
    Nyack Hospital
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  • Idk, ridiculous I agree, but I think you could technically count it as 4 but I always that one was an all-inclusive!

    Karyn Cardenas-Foray, CPC, CPMA ,CHCA, CEMC,CIMC,CSEMC
    Government Reimbursement Analyst-Sharp Health Care
    PFS-CCD 3rd Floor

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