jod867
Networker
so I have a question. Im in the middle of doing some internal audits and My question is Only on the MDM portion. when Calculating the MDM you must meet 2 out of 3 of the components. So I just want to make sure I'm understand this correctly so I don't "butt heads" with my Providers for no good reason. I have a example the pt is on Adderal so its a Moderate risk. However that is the only reason for the appointment meaning that there is only 1 point for the DX and No data was reviewed. making it a straight forward MDM. Is that correct?
Now to the entire portion... if that is correct and based on the audit tool through the AAPC that I have it states that for an est patient the MDM needs to be 1 of the 2 for the 2 out of 3 that must be met to support the Medical necessity. so even if I have a detailed history and a detailed exam based on the MDM I can not put it as a 99214 it would have to be a 99212 for the MDM to be 1 of the 2. Is that correct?
Any Help on this would be great. I think I have it but want to double check.
Now to the entire portion... if that is correct and based on the audit tool through the AAPC that I have it states that for an est patient the MDM needs to be 1 of the 2 for the 2 out of 3 that must be met to support the Medical necessity. so even if I have a detailed history and a detailed exam based on the MDM I can not put it as a 99214 it would have to be a 99212 for the MDM to be 1 of the 2. Is that correct?
Any Help on this would be great. I think I have it but want to double check.