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Food as Medicine Shared Medical Appointment Medical Decision Making

R

rmness

Networker
Messages
36
Location
Fargo
Our facility is performing shared medical appointments and the current focus is Food As Medicine. They counsel the patients about the effects of sugar on mental health, following a non-inflammatory diet, how certain foods affect metabolic health, etc. For each individual the provider's treatment plan is to follow a healthier diet and to routinely exercise. Where would this treatment fall in the risk category for medical decision-making?
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sorry, i am not an expert. i would say Low MDM unless that pt has a significant reaction to a specific food, maybe i would upgrade the level to moderate. What comes to my mind, pt was told not to eat 'specific food' because it increases his blood sugar that already led to coma etc but pt does not stick to the recommendations and keeps eating ' specific food' = moderate risk because we know that this pt more likely will be in ED again, and again.
 
jkyles said:
To clarify - this is group counseling?
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Yes. There was a previous post about determining the E/M level that has more details and context: https://www.aapc.com/discuss/threads/what-e-m-level.236076/

(IMO, I think that the poster understands that this isn't an E/M service, but perhaps is getting pressure from the provider to bill it that way anyhow. At least, that's how I read between the lines in the other thread. I could be wrong.)
 
jkyles said:
To clarify - this is group counseling?
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Correct, they meet in a group they discuss different foods and how they affect patient health. They do meet with patient's individually as well and create an individualized plan as well. The provider thinks the recommendations in regards to eating a better diet and exercising warrant MDM risk higher than straightforward, which I disagree with.
 
sls314 said:
Yes. There was a previous post about determining the E/M level that has more details and context: https://www.aapc.com/discuss/threads/what-e-m-level.236076/

(IMO, I think that the poster understands that this isn't an E/M service, but perhaps is getting pressure from the provider to bill it that way anyhow. At least, that's how I read between the lines in the other thread. I could be wrong.)
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That specific example the patient didn't have one on one with the provider, but for the ones who do meet individually with the provider, the provider thinks eat a better diet and exercise more warrant a higher risk MDM level than straightforward, which I disagree with as well.
 
rmness said:
That specific example the patient didn't have one on one with the provider, but for the ones who do meet individually with the provider, the provider thinks eat a better diet and exercise more warrant a higher risk MDM level than straightforward, which I disagree with as well.
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I agree with you.

In those one on one visits, telling them to eat better and exercise more is clearly minimal risk.

I wonder if there's some confusion about what the Risk column is evaluating. Does the provider understand that this element refers to the risk associated with the diagnostic testing or treatment decisions being made?

Perhaps they're interpreting "risk" as the patient's underlying risk from their diagnoses or chronic conditions? Not understanding that those are captured in the Number and Complexity of Problems Addressed element?
 
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