Hi! I wouldn't count the DM as an established problem, unless the doctor actually addressed it (asked about blood sugars, recommended diet/Rx change, etc.) You can take it into consideration as a comorbidity that could complicate the MDM for the hand pain, but I wouldn't give it more credit than that if it was just casually mentioned. New problem w/addl. workup sounds good on the hand pain, if the doctor hasn't dismissed the cause as something trivial, which will be obvious in the plan. If all he recommended was an ice pack and aspirin, then I'd consider MDM straightforward. It's not just what the problems are that make up MDM...it's what the doctor did about it, too.