Yes. Be careful cyanosis is really related to CV. and could be skin.
Maxine Lewis, CMM, CPC, CPC-I, CPMA, CCS-P
Main: 513-771-7070 Direct: 513-672-4363
Fax: 513-326-7640
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I agree. I have always seen clubbing as CV but I do know that it is listed under MS in many of the tools. I can see bruising as skin but not cyanosis but you may have something showing otherwise.
We had an auditor who stated just the documentation of "clubbing and cyanosis" is not enough to support the musculoskeletal exam of an organ system. I have always given this statement credit in the extremity section of the note. To meet the requirement for musc. organ system you would need to document about the muscle tone, gait, stability, joints, etc.
That is that auditors personal opinion but it is not supported by any official source.
CMS guidelines clearly list it as part of the musculoskeletal organ system. "Inspection and/or palpation of digits and nails (e.g., clubbing, cyanosis, inflammatory conditions, petechia, ischemia, infections, nodes)"
TT
Todd Thomas, CPC, CCS-P ERcoder, Inc President 941 NW 164th, Suite 1 todd@ercoder.com Edmond, OK 73013 (405) 749-2633 www.ERcoder.com
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It is truly amazing how E/M Guidelines are so subjective and open to interpretation. I wonder if the Cost portion of MIPS will be also when it comes to the risk area. Maxine
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As I posted earlier the 1997 guidelines sometimes list it in musculoskeletal and sometimes in extremities depending on the specialty exam. BUT it is not part of either for the musculoskeletal specialty exam.
If you are using the 1997 guidelines for general multi-system exam, clubbing & cyanosis do fall into the musculo-skeletal system box. Check the CMS Evaluation & Management Guidelines manual.
Donna M. Beaulieu, C-CDI, CPMA, CPC-I, CRC, CPC, CEMC, CIMC, CEDC, CFPC, CCP-P, CRP Certified Green Belt, Lean Six Sigma Assistant Director, Patient Financial Services Emory Healthcare 404-778-6688
But in other specialty exams it falls under extremity. To me it really is a wash unless you are going for a comprehensive exam where extremity would not count towards the 8 required under 1995 guidelines.
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Comments
Maxine Lewis, CMM, CPC, CPC-I, CPMA, CCS-P
Main: 513-771-7070
Direct: 513-672-4363
Fax: 513-326-7640
200 Northland Blvd
Cincinnati, OH 45246
mlewis@scrogginsgrear.com
www.scrogginsgrear.com
This electronic message transmission contains information from ScrogginsGrear, Inc. which may be confidential or privileged. The information is intended for the use of the individual or entity named above. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic transmission in error, please notify us by telephone (800-359-3970) or by electronic mail (consultants@scrogginsgrear.com) immediately. If any tax advice is contained in this communication, it is not intended or written to be used for the purpose of avoiding any penalties that may be imposed under federal law and cannot be used for that purpose.
Karyn Cardenas-Foray, CPC, CPMA ,CHCA, CEMC,CIMC,CSEMC
AHIMA ICD10 PROFICIENT
Government Reimbursement Analyst-Sharp Health Care
PFS-CCD 3rd Floor
858-499-4382
Is Clubbing and Cyanosis enough to support the musculoskeletal exam of an organ system?
Karyn Cardenas-Foray, CPC, CPMA ,CHCA, CEMC,CIMC,CSEMC
AHIMA ICD10 PROFICIENT
Government Reimbursement Analyst-Sharp Health Care
PFS-CCD 3rd Floor
858-499-4382
stem?
I agree. I have always seen clubbing as CV but I do know that it is listed
under MS in many of the tools. I can see bruising as skin but not cyanosis
but you may have something showing otherwise.
But we had another auditor who disagreed.
CMS guidelines clearly list it as part of the musculoskeletal organ system. "Inspection and/or palpation of digits and nails (e.g., clubbing, cyanosis, inflammatory conditions, petechia, ischemia, infections, nodes)"
TT
Todd Thomas, CPC, CCS-P ERcoder, Inc
President 941 NW 164th, Suite 1
todd@ercoder.com Edmond, OK 73013
(405) 749-2633 www.ERcoder.com
Confidentiality notice: This communication and any accompanying file may contain confidential and/or privileged information. They are intended for the sole use of the addressee for business pertaining to ERcoder, Inc. If you received this transmission in error, you are advised that any disclosure, copying, distribution, or the taking of any action in reliance upon the communication is strictly prohibited.
Maxine
Maxine Lewis, CMM, CPC, CPC-I, CCS-P, CPMA
Main: 513-771-7070
Direct: 513-672-4363
Fax: 513-326-7640
200 Northland Blvd
Cincinnati, OH 45246
mlewis@scrogginsgrear.com
www.scrogginsgrear.com
This electronic message transmission contains information from ScrogginsGrear, Inc. which may be confidential or privileged. The information is intended for the use of the individual or entity named above. If you are not the intended recipient, be aware that any disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic transmission in error, please notify us by telephone (800-359-3970) or by electronic mail (consultants@scrogginsgrear.com) immediately. If any tax advice is contained in this communication, it is not intended or written to be used for the purpose of avoiding any penalties that may be imposed under federal law and cannot be used for that purpose.
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If you are using the 1997 guidelines for general multi-system exam, clubbing & cyanosis do fall into the musculo-skeletal system box. Check the CMS Evaluation & Management Guidelines manual.
Donna M. Beaulieu, C-CDI, CPMA, CPC-I, CRC, CPC, CEMC, CIMC, CEDC, CFPC, CCP-P, CRP
Certified Green Belt, Lean Six Sigma
Assistant Director, Patient Financial Services
Emory Healthcare
404-778-6688
But in other specialty exams it falls under extremity. To me it really is
a wash unless you are going for a comprehensive exam where extremity would
not count towards the 8 required under 1995 guidelines.
Ruby Woodward
Sent from my iPhone
Karyn Cardenas-Foray, CPC, CPMA ,CHCA, CEMC,CIMC,CSEMC
AHIMA ICD10 PROFICIENT
Government Reimbursement Analyst-Sharp Health Care
PFS-CCD 3rd Floor
858-499-4382
yes it is
Karyn Cardenas-Foray, CPC, CPMA ,CHCA, CEMC,CIMC,CSEMC
AHIMA ICD10 PROFICIENT
Hi there! What is the latest situation? I want to find out if anything could change in view of recent events with quarantine. There should not be any amendments due to it, I hope. But I cannot find the latest guidance from my location https://worldcams.tv/united-kingdom/london/city-views. It would be great if someone can check and advise the details, or share the link to read.
To be honest, I have no idea how people are able to play it and this is really difficult. I remember that I decided to check this about the best 49 key midi controller and it also seems rather difficult. However, if you like it, you should listen to your heart and buy it.