Wiki Level of Service and the MDM

skraft1969

Networker
Messages
31
Location
Peoria, Illinois
Best answers
0
During both the legal panel and e/m panel there were questions about definitions of prescription drug management. One example is a patient coming in for a cough and given an antibiotic. The billed service is a 99214 but the panel all said in no world would that be a 99214. This is concerning because per Medicare they describe a new medication as moderate risk. If the provider documents a detailed history an problem focused exam, and moderate MDM this should be a 99214.

https://med.noridianmedicare.com/web/jeb/education/event-materials/em-qa

Q11. What does "prescription drug management" consist of? For example, if a provider prescribes Motrin 800mg or a course of antibiotics, would this be considered "Prescription drug management" within the MDM?
A11. Prescription drug management is for managing the drug regimen. This is not just a listing the patient's medications. It is for new drugs prescribed, evaluation and raise or lower drug dosages, etc.
 
Last edited:
It'll boil down to how much time the doctor actually spent with the patient.

Peace
@_*
Good documentation will support most claims. Just saying.
 
MDM vs. Moderate Level of Risk

Moderate Risk does not always equate to a moderate MDM. Writing a prescription does make it a moderate level of risk, but that is only one of three parts to the MDM equation.

Michele Davis, CPC, CPMA, CRC, CPC-I
 
Mdm

Hi,

I am agree with Michele Davis to calculate a over all MDM required All the components such as

1.Number of presenting Diagnosis - Table A
2.Date points - Table B
3.Risk -Table C

We can not take MDM Moderate based on prescription drug and also there is cut off factor is medical necessity for cough is minor problem its not support for moderate complexity of MDM
 
Top