• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Low vs Mod

Create Wiki
M

msingh23

Guru
Messages
131
Best answers
0
I consider this as Low complex, Dr say mod for its X ray order , now I know 1,2 or 10 X-ray exam, same cedit, can the dx impact the credit here to be mod or I stand as Low complex.

X-ray exam, cervical spine AP/lateral/oblique
X-ray exam, shoulder, complete, 2+ views
Dx Pain soft tissue ot limb729.5
Syndrome 353.0
thanks for your feedback.
 
Sorry Looking for MDM Components.
I consider this as Low complex MDM , Dr say mod,now I know 1,2 or 10 X-ray exam, same cedit, and service discussed is differ than provided service, can this impact the credit here to be mod or Low complex, MDM

Plan:
x-ray C spine and R GH
Pain is vague in BUE...
nerve vs RC
consider MRI re: TOS
X-ray exam, cervical spine AP/lateral/oblique
X-ray exam, shoulder, complete, 2+ views
Dx Pain soft tissue ot limb729.5
Syndrome 353.0

Thanks for your feedback.
 
Last edited:
I do know that if he bills for doing the X-rays he does not get the points since he will be paid for the X-rays. That is if he bills both TC and prof.
 
The answer to your question is not straight forward.

If the doctor only ordered the x-rays, he would get 1 point under data reviewed. If he states that he independently looked at the films and documents his findings, then he would get 2 points instead of 1. If the x-rays were taken in the office and are billed by his office, he would not get any credit under data reviewed.

Depending on what you come up with under the other 2 areas of MDM would determine if this is moderate or low. If this is a new problem to this physician and he is ordering the x-rays to be done outside the office, than he could get 4 points for treatment options. If it is a new problem, but the x-rays are being taken in the office, then 3 points. If this is an established problem, it depends on whether it is stable or worsening - which you did not indicate. So, if it is an established problem, with the 1 or 2 points from the data reviewed, the MDM could either be straight forward or low. If it is new, your level would now depend on whether the risk is low or moderate.

Based on the diagnosis you have it looks like the risk would be low - so in this case the MDM would probably be low, but not moderate.
 
You must log in or register to reply here.
Top