Wiki High level of risk for consults

[coder25]

I was wondering if there was some way to determine whether or not something is considered high risk for E/M? I read on an ophthalmology website that a perforated corneal ulcer/acute glaucoma/ruptured globe requiring surgery/recurrent retinal detachment requiring surgery are all considered high risk, but are there other diagnoses that would fit that criteria? (Do you agree)? It seems like most of the consults are of moderate decision making, and my physician feels that they should be high risk. Thanks in advance for your help!

 

[patcpc]

It would depend on a number of factors in the documentation. Check your 1995 and 1997 guidelines:

http://www.cms.gov/Outreach-and-Edu...N/MLNEdWebGuide/Downloads/95Docguidelines.pdf

http://www.cms.gov/Outreach-and-Edu...N/MLNEdWebGuide/Downloads/97Docguidelines.pdf

and for a website specifically helpful to high medical decision making:
http://emuniversity.com/HighComplexityMedicalDecision-Making.html