Question I have a few questions on the level of Risk for the new 2021 guidelines for codes 99202-99215

Sylmonia

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1. Would a prescription for orthotics or gel insoles be considered low risk?
2. Can we use the current 1997/95 grid, example PT?
3. closed fx care without manipulation was previously moderate risk, would " with manipulation" be the same?
4. Addressing, diagnosing and referring to another specialist for fracture care and just splinted, would this be considered "low risk"?

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Syl
 

Bernadette10

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I would answer yes to all these questions, mainly because of this statement from this article Evaluation and Management (E/M) Code Changes 2021 - AAPC that's about halfway down the page.
"The terms high, medium, low, and minimal risk are meant to reflect the common meanings used by clinicians. For MDM, base risk on the consequences of the addressed problems when they’re appropriately treated."
I think this is very vague, and whoever writes the guidelines could have been more specific and given more examples, but for now I haven't found anything else to go by.
 
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