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Pediatric Coding Alert

Guidelines:

Make the Decision, Add Up the Points in This MDM Calculation

Published on Thu Apr 18, 2019

And know that numbers alone don’t always equate to the correct E/M level. More than history and the exam, the Centers for Medicare and Medicaid (CMS) regard medical decision making (MDM) “and time [as] the more significant factors in distinguishing visit levels” (Source: www.gpo.gov/fdsys/pkg/FR-2017-11-15/pdf/2017-23953.pdf). But calculating MDM often involves making judgement calls that can sometimes lead to upcoding or [...]
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