COMPETENCY EXAM STUDY GUIDE X-
X. REAL-LIFE QME PRACTICE WITH
COMPLETE SOLUTIONS
No medical records are received by a QME prior to or after the evaluation. The QME
issues a report within the 30-day time limit. Medical records are then received. What
should the QME do? - ANSWER-Review the records and issue a supplemental report
detailing the new findings and updating any opinions that the new information may have
affected.
No medical records are received by a QME prior to or after the evaluation. Must the
QME still issue a medical-legal report? How many days does the QME have to issue the
report? - ANSWER-Yes. 30 days as per usual.
No medical records are received by a QME prior to or after the evaluation. Technically,
can the QME contact the injured worker's primary treating physician to get the records?
- ANSWER-Yes
If an injured worker does not speak English, then they're entitled to a certified (by the
state of California) interpreter. What must the QME document in the report? - ANSWER-
The name and the certification number of the interpreter.
Define: precipitation. - ANSWER-Precipitation is when work exposure causes a
previously asymptomatic condition or problem to manifest.
Define: acceleration. - ANSWER-Acceleration is when work exposure makes a
previously asymptomatic condition or problem manifest sooner than without work. It also
refers to work exposure rapidly worsening a condition.
Modifiers are added to billing codes. A -92 modifier means what? - ANSWER-That the
evaluation was performed by the primary treating physician (PTP).
Modifiers are added to billing codes. A -93 modifier means what? - ANSWER-That the
evaluator had the help of a certified interpreter.
Modifiers are added to billing codes. A -94 modifier means what? - ANSWER-That the
evaluation was an AME.
Modifiers are added to billing codes. A -95 modifier means what? - ANSWER-That the
evaluation was an QME.
X. REAL-LIFE QME PRACTICE WITH
COMPLETE SOLUTIONS
No medical records are received by a QME prior to or after the evaluation. The QME
issues a report within the 30-day time limit. Medical records are then received. What
should the QME do? - ANSWER-Review the records and issue a supplemental report
detailing the new findings and updating any opinions that the new information may have
affected.
No medical records are received by a QME prior to or after the evaluation. Must the
QME still issue a medical-legal report? How many days does the QME have to issue the
report? - ANSWER-Yes. 30 days as per usual.
No medical records are received by a QME prior to or after the evaluation. Technically,
can the QME contact the injured worker's primary treating physician to get the records?
- ANSWER-Yes
If an injured worker does not speak English, then they're entitled to a certified (by the
state of California) interpreter. What must the QME document in the report? - ANSWER-
The name and the certification number of the interpreter.
Define: precipitation. - ANSWER-Precipitation is when work exposure causes a
previously asymptomatic condition or problem to manifest.
Define: acceleration. - ANSWER-Acceleration is when work exposure makes a
previously asymptomatic condition or problem manifest sooner than without work. It also
refers to work exposure rapidly worsening a condition.
Modifiers are added to billing codes. A -92 modifier means what? - ANSWER-That the
evaluation was performed by the primary treating physician (PTP).
Modifiers are added to billing codes. A -93 modifier means what? - ANSWER-That the
evaluator had the help of a certified interpreter.
Modifiers are added to billing codes. A -94 modifier means what? - ANSWER-That the
evaluation was an AME.
Modifiers are added to billing codes. A -95 modifier means what? - ANSWER-That the
evaluation was an QME.
