MDM - Prescription Management

KIMST1977

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I have a question about prescription management for medical decision making (MDM). I was recently told by a co-worker if a provider prescribes a "short term" (0-10 day) medication, the MDM becomes Low. It has always been my understanding prescription management falls into Moderate MDM. Has anyone else heard of this? If this is correct can you also point me to where I can locate this information in writing?
 

twizzle

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Your co-worker is not entirely correct and you will find nothing in writing to support it unless it is a client-specific guideline. I have known clients whose guidelines might say that for a short (7 day) course of antibiotics for an acute uncomplicated problem, the MDM is low. Others say that any Rx drug management carries a risk and that is certainly true.
Your co-worker is saying that a Rx for an opiate drug for up to 10 days is low risk which is clearly ridiculous. These drugs carry a high risk of addiction as we all know.
As a very general rule you should view Rx drug management as moderate MDM but specific clients may have specific policies. Check with them first and always be wary of what your co-workers say.
 

Pathos

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Another way of thinking about this: imagine your clinic is selected for an audit and the chart you are auditing is in question. If the MDM is being questioned, you will need to provide solid references as backup to support your MDM level. The words of a co-worker, or even your coding manager will not hold up in such a situation. However, clear references from CMS, AMA, or relevant AHA Coding Clinics could provide a strong case for your argument.
 
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