Screening vs. comprehensive neurological examination?
While CMS acknowledges that there is no precise definition of a screening neurological examination it does at minimum call for a gross assessment of the central nervous system (CNS) and specifically points out the unacceptability of using the statement “Cranial Nerves II to XII intact”. The same would hold true for indicating ‘WNL’ beside the cranial nerve divisions as a description (vs. interpretation) of the testing performed is what is desired. In a comprehensive neurological examination, CMS expects ‘detailed, fine testing’. Such an exam would be expected (in descriptive fashion) when indicated by the screening exam, a system review that indicates positive neurological symptoms or an accurate baseline of neurological functioning is important (e.g., patients for ECT).
