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Posts: 2
Reply with quote  #1 
I need to order some pocket coding tools (Tx) but am wondering if E/M university will be updating or changing the tools to reflect Novitas requirements - or if that will be needed. We are trying to get prepared so are looking for a good tool to assist.  Reviewed it and see a few differences (MDM tool, Detailed Exam using Novitas 4X4 instructions as well as current instructions, and the ability to use "all other systems negetive" in ROS. 

Will the tool be updated (as we so appreciated when it was done for J4 Trailblazers)?

Posts: 3
Reply with quote  #2 
I have a similar question: are the requirements for Novitas now similar to those for the rest of the country, or are there quirks such as there were for Trailblazer?

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Posts: 773
Reply with quote  #3 
We do not have a specific coding guide for Novitas.  As far as I know, they follow the standard MDM rules.  As far as the slight differences in the 95 exam and the use of the "shortcuts,' every doc should check with their individual carrier to confirm which "rules" they choose to follow.  PJ.

Posts: 2
Reply with quote  #4 


The main differences I see are:

ROS: allows "all others negative" when documented with pertinent negatives/positives of other systems for a Complete ROS

Exam: Novitas training (on their site - E&M Scorecard webinars) indicates that a Detailed exam can be met when documentation of 4 elements of 4 different systems/areas support the exam

MDM- different design of tool with changes to the "number of DX/treatment options" and "amount/complexity of data reviewed" - risk table stays the same.  Seems simpler. 

I like the E\M University tool because it is such a comprehensive blend of both 95 and 97 guidelines and we use both extensively.  Will figure out a way to make it work.  Thanks!

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