Wiki Low vs Medium question

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I'm looking over Ch17 E&M of the CPC Study Guide and want to make sure that I'm understanding chapter quiz question #10 correctly.
The HPI states that they've had left knee pain for approximately one month. Later in the chart, it's diagnosed as OA.

Is the fact that it was diagnosed at some point why it's considered an acute injury (Low) rather than a new problem (Med/High)?
If this is the case, when do we use "New problem with/without addl work-up planned"?

Thanks.
 
I think maybe you are mixing/matching different guidelines.
Outpatient E/M need to follow the new guidelines established in 2021. Level is based on medical decision making only.
Inpatient E/M need to follow either 1995 or 1997 guidelines. Level is based on history, exam and medical decision making.
The components of medical decision making are different as well.
 
I think maybe you are mixing/matching different guidelines.
Outpatient E/M need to follow the new guidelines established in 2021. Level is based on medical decision making only.
Inpatient E/M need to follow either 1995 or 1997 guidelines. Level is based on history, exam and medical decision making.
The components of medical decision making are different as well.

If only it were that simple.
As you know MDM is a result of three different factors. I'm just trying to understand why they said that the first of those, Number & Complexity of Problem(s) Addressed, was Acute Uncomplicated - Low and not New Problem - Moderate.
Guessing that it's because they were able to diagnose it by the end of the encounter (from Pain to AO) but I'm not sure...
 
I still think you may be confusing or mixing/matching guidelines. Whether or not the problem is new does not matter for 2021 outpatient guidelines. It does matter for one of the three components of MDM for 1995/1997, of which MDM is only one of three elements (history and exam being the other 2).
While I do like the 2021 outpatient changes overall, it gets SUPER confusing, particularly for newer coders since the old (1995/1997) guidelines are still used for inpatient. The components may have same/similar titles, but with different definitions of them. So MDM for an inpatient and MDM for an outpatient currently are 2 different definitions.
I don't have access to your study guide, know what year the study guide is, know whether this is inpatient or outpatient, so without additional information it would be difficult for anyone to provide additional guidance.
IF this is inpatient following 1995/1997 guidelines or outpatient prior to 1/1/2021 AND IF this was a new problem to the examiner, then this likely would be considered a new problem without additional workup.
IF this is outpatient after 1/1/2021, then likely acute uncomplicated.
New problem is on a different table using different guidelines than acute uncomplicated.
 
I still think you may be confusing or mixing/matching guidelines. Whether or not the problem is new does not matter for 2021 outpatient guidelines. It does matter for one of the three components of MDM for 1995/1997, of which MDM is only one of three elements (history and exam being the other 2).
While I do like the 2021 outpatient changes overall, it gets SUPER confusing, particularly for newer coders since the old (1995/1997) guidelines are still used for inpatient. The components may have same/similar titles, but with different definitions of them. So MDM for an inpatient and MDM for an outpatient currently are 2 different definitions.
I don't have access to your study guide, know what year the study guide is, know whether this is inpatient or outpatient, so without additional information it would be difficult for anyone to provide additional guidance.
IF this is inpatient following 1995/1997 guidelines or outpatient prior to 1/1/2021 AND IF this was a new problem to the examiner, then this likely would be considered a new problem without additional workup.
IF this is outpatient after 1/1/2021, then likely acute uncomplicated.
New problem is on a different table using different guidelines than acute uncomplicated.
It's the 2022 AAPC CPC Study Guide. I got it for review since we haven't done E&M in a while and will be starting again at the facility I'm at and the guide seems to contradict itself.
 
Agree with Christine.
There is not enough information to determine if there is contradiction, if the question/answer is correct, or possible you are mixing E/M guidelines. We would need to know if it was office/outpatient or inpatient, ED, Consult or Observation.
I also agree that it can be very confusing for newer coders because of having to know and understand both guidelines. If a coder did not have a good understanding or grasp of 95/97 it is difficult to learn & understand 2021 office/outpatient and vice versa. One learning tool I used for folks was coding it both ways and comparing just to understand the guidelines and differences.
 
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