Title: Competency Assessment: (CU2 M4) "The Exam" Roleplay
Course: SkillsCom CMA 111 16.0 > Section: Credit Unit 2 Module 4

You are working as the Coding and Billing Supervisor in a medical office.  Your staff is having difficulty interpreting "The Exam" documentation.  The documentation should consist of the method, location, and the findings from performing "The Exam", but a coder has to recognize these elements/components in order to properly bill.  For additional information on this, check out this article produced by the American Academy of Family Physicians: Exam Documentation (Webpage).

You have decided to have a professional development training with your staff in order to demonstrate a physical physical exam.  You are going to do a role play with someone and act as the physician who is doing an examination on a patient.

1. Develop an exam template and use it to conduct a patient exam on a partner.

- You will not need to submit the script until the next Competency Assessment, but you will need it to complete this assessment.

2. Ask someone to role-play with you.

- Instruct your partner that they have back pain and type II diabetes.
- You will do a "mock" examination of your partner.
  - Using the 9 methods of examination, examine your partner's body areas and organ systems that are relevant to their chief complaint. (You do not need to use all 9 methods, you do need to determine which are the best to use.)
  - Rules:
    - Your partner is to remain fully clothed.
    - No breast exams.
    - No pelvic area exams
    - Always explain each exam to the patient first so they may refuse if desired.
- Determine which body systems these 2 complaints are related to.

3. Videotape the role play and upload it to be graded.