According to the 1995 and 1997 guidelines, how many components are required for established patients to determine the correct code?

To determine the correct code for established patients in accordance with the 1995 and 1997 guidelines, it is essential to understand the components involved in the evaluation and management documentation. For established patients, these guidelines stipulate that at least two out of three components—history, examination, and medical decision-making—must be satisfied to select the appropriate level of service and corresponding code.

The distinction between the different components plays a crucial role in the coding process; the history includes the patient's medical background and reasons for the visit, the examination refers to the physical assessment conducted, and medical decision-making involves the complexity of the diagnosis and treatment options discussed. By requiring two out of the three components to be met, the guidelines provide flexibility while also maintaining a structured approach to coding that ensures thoroughness in care documentation.

Moreover, understanding these requirements is fundamental for medical auditors to uphold coding accuracy and compliance, as incorrect coding can lead to issues with reimbursements and audits.