Actinic Keratosis- MDM

sblacke68

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Hello, given the prevalence and success of treatment of AK's in the general population, even though they are pre-malignant, when considering problem points would AK's rate as a self-limited/ minor, or as a problem (est or new)? Should this be quantified, say, 3 or more constitute a problem?

Thanks!
 

sblacke68

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Pre-malignant with skin cancers doesn't have quite the same serious tone that other cancers do. Although they account for the vast majority of cancers, they rarely (less than 2%) metastasize and lead to death, the vast majority only cause some local damage if untreated. Thing is, approximately half the general population will have an AK, SCC, or BCC in their lifetime and I'm concerned about raising the MDM level every time a person comes in with only one or two spots for treatment. I get what you're saying, though, but as I want this office to be audit-worthy, I wanted to get some feedback on this. :)
 

thomas7331

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An interesting question from an MDM/E&M standpoint. Because it's a relatively low risk condition that typically doesn't require substantial data or workup, I'd consider it straightforward to low MDM depending whether the patient and/or condition are new to the provider. That said, since it's usually also treated via minor procedure at the time of the encounter, there often isn't a separate E&M warranted (unless the provider is addressing other issues in the same visit) so it's something of a moot point. And of course, with the disclaimer that it really always depends on what the documentation says.
 
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