Cardiovascular exam as per Medicare requirement

Constitutional 
Measurement of any three of the following seven vital signs: 1) sitting or standing blood pressure, 2) supine blood pressure, 3) pulse rate and regularity, 4) respiration, 5) temperature, 6) height, 7) weight (May be measured and recorded by ancillary staff)
General appearance of patient (eg, development, nutrition, body habitus, deformities, attention to grooming)[text name="field_name" default="sample text"]
Eyes
Inspection of conjunctivae and lids (eg, xanthelasma)[textarea name="field_name" default="sample text"]
Ears, NOse, Mouth and Throat
Inspection of teeth, gums and palate
Inspection of oral mucosa with notation of presence of pallor or cyanosis [textarea name="field_name" default="sample text"]
Neck 
 Examination of jugular veins (eg, distension; a, v or cannon a waves) Examination of thyroid (eg, enlargement, tenderness, mass)
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Respiratory
Assessment of respiratory effort (eg, intercostal retractions, use of accessory muscles, diaphragmatic movement)
Auscultation of lungs (eg, breath sounds, adventitious sounds, rubs)
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Cardiovascular
Palpation of heart (eg, location, size and forcefulness of the point of maximal impact; thrills; lifts; palpable S3 or S4)
Auscultation of heart including sounds, abnormal sounds and murmurs Measurement of blood pressure in two or more extremities when indicated (eg, aortic dissection, coarctation)
Examination of:
Carotid arteries (eg, waveform, pulse amplitude, bruits, apical-carotid delay) Abdominal aorta (eg, size, bruits)
Femoral arteries (eg, pulse amplitude, bruits)
Pedal pulses (eg, pulse amplitude)
Extremities for peripheral edema and/or varicosities
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Gastrointestinal
Examination of abdomen with notation of presence of masses or tenderness Examination of liver and spleen
Obtain stool sample for occult blood from patients who are being considered for thrombolytic or anticoagulant therapy[textarea name="field_name" default="sample text"]
Musculoskeletal 
Examination of the back with notation of kyphosis or scoliosis
Examination of gait with notation of ability to undergo exercise testing and/or participation in exercise programs
Assessment of muscle strength and tone (eg, flaccid, cog wheel, spastic) with notation of any atrophy and abnormal movements[textarea name="field_name" default="sample text"]
Extremities
Inspection and palpation of digits and nails (eg, clubbing, cyanosis, inflammation, petechiae, ischemia, infections, Osler’s nodes)[textarea name="field_name" default="sample text"]
Skin
Inspection and/or palpation of skin and subcutaneous tissue (eg, stasis dermatitis, ulcers, scars, xanthomas)[textarea name="field_name" default="sample text"]
Neurologic/Psychiatric
Brief assessment of mental status including
Orientation to time, place and person,
Mood and affect (eg, depression, anxiety, agitation)
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