Mdm? - If the assessment is Cellulitis

veloso

Guru
Messages
227
Best answers
0
Hi All,
If the assessment is Cellulitis and the HPI,PE all Detailed and the MDM Rx. Bactrim and no additional work-up done.
Would the Level of Service be 99213 or 99214 pls. needs help..

Thanks
 

shruthi

Guru
Messages
135
Location
Mysore, Karnataka
Best answers
0
Hi All,
If the assessment is Cellulitis and the HPI,PE all Detailed and the MDM Rx. Bactrim and no additional work-up done.
Would the Level of Service be 99213 or 99214 pls. needs help..

Thanks
For est patient visit, documentation requires 2 of 3 components to be satisfied. Since in your case HPI and PE are both detailed, level will be 99214. (MDM can be moderate or low still level will not change)
 

linc11

Networker
Messages
37
Location
Montgomery, TX
Best answers
0
I agree with Shruthi, the level is 99214 regardless of your level of MDM. However, I do prefer that one of the determining factors of the level of the visit be the MDM. Otherwise we use our judgement and may drop the level of service based on the MDM.
 
Messages
4,466
Location
Milwaukee WI
Best answers
0
HISTORY vs HPI

HPI is only ONE element of History

If your HPI is detailed (i.e. 4+ elements (or status of 3 chronic illnesses for 1997 guidelines), you STILL need at least 2 systems in ROS and 1 element of PFSH to qualify for a detailed HISTORY. (Or 10+ ROS and all three of PFSH for Comprehensive HISTORY).

Now about your MDM
Prescription drug management is moderate RISK, but in order to have a moderate MDM you must also have at least 3 problem points OR at least 3 data points. Risk, by itself, does not equal MDM.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 

dclark7

True Blue
Messages
723
Location
Hartford, CT
Best answers
0
You should also check with your insurance company, some (for instance Anthem of CT) have stated in their policies that they require MDM as one of the two elements for established patients the other element can be either Hx or exam.
 
Top