Wiki High complexity problems addressed for orthopedics level 5 E/M

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Lisa Strickler

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I am looking for some input on what guidelines are being used for High complexity of problems addressed, in regards to orthopedics. Our providers seem to think about it differently than I do. They feel that deciding to do surgery on a rotator cuff, ACL etc is considered high complexity and I do not. Part of the problem is there doesn't seem to be good examples of orthopedic problems that are of high complexity. I would appreciate any help or ideas
 
The complexity of the problems addressed and the risk of management are 2 separate things.
For example, the risk could be considered high due to decision regarding major surgery with identified patient or procedure risk factors, but that does not necessarily mean the complexity of problems is high.

The AMA 2021 Outpatient Guide provides a lot of more in-depth information that the CPT book does. It further explains risk, and whether or not a chronic illness is stable.

Hope that helps you!
 
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