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Wiki Mdm

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nyyankees

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If a dr refers their patient to a general surgeon what level of risk would you give that? Does the fact that it's a surgeon allow a Moderate risk level?
 
AGPersaud said:
It depends on the amount of work/counseling the doctors spent with the patient. Depending on the severity of the dx and care, I would code a LOS 3 or 4.
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The patient has a lump on his back and that's why she refered him to a general surgeon. Could that give me a Risk level of moderate in my MDM calculations? That's what I am not 100% sure of. Thanks.
 
AGPersaud said:
If the referring doctor did not order/review labs, x-rays, and did a brief exam, I would give it a LOS 3.
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It's not the LOS I am asking about. My question is in the MDM does the decision making of sending a patient to a surgeon support a Moderate Risk in the Risk porion of the MDM. I am not billing the refered doc (general surgeon) but for the doc that is sending the patient to the surgeon. Thanks again.
 
I would assign moderate risk level based on the nature of the presenting problem. "Lump in the back" certainly qualifies as an undiagnosed new problem.
 
Yeah, I would go more based on the nature of the presenting problem in this case. Just the mere fact that they are sent to a surgeon does not necessarily mean the overall risk is moderate.

It stands to reason that if the provider is selecting that management option, the patient probably does have either a new problem with uncertain prognosis, or a chronic problem with mild progression. Those situations DO qualify as moderate risk.
 
MikeEnos said:
Yeah, I would go more based on the nature of the presenting problem in this case. Just the mere fact that they are sent to a surgeon does not necessarily mean the overall risk is moderate.

It stands to reason that if the provider is selecting that management option, the patient probably does have either a new problem with uncertain prognosis, or a chronic problem with mild progression. Those situations DO qualify as moderate risk.
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thanks.
 
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