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MEAT criteria and which encounters to use it in?

T

Tharville

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Hello,

If you have criteria that meets MEAT, would you consider coding it, no matter what type of encounter it might be. For example, outpatient or inpatient? Is it one or the other, or can it be used for both?

Thanks.
 
Tharville said:
Hello,

If you have criteria that meets MEAT, would you consider coding it, no matter what type of encounter it might be. For example, outpatient or inpatient? Is it one or the other, or can it be used for both?

Thanks.
Click to expand...
Tharville.....the classic MEAT framework (Monitor, Evaluate, Assess, Treat) is standard for inpatient and outpatient clinical evaluation. TAMPER is for risk adjustment or HCC coding. This helps validate a diagnosis, a medical coder asks, "Did the provider TAMPER with the diagnosis during this encounter?" If the medical record shows evidence of at least one of these actions, the code can be safely reported:
  • T - Treatment: The provider prescribed therapies, ordered procedures, or recommended active care for the condition.
  • A - Assessment: The provider evaluated the status, progression, or regression of the disease during the visit.
  • M - Monitor / Medicate: The provider checked signs/symptoms, reviewed labs, or managed/adjusted specific medications for the disease.
  • P - Plan: The provider outlined a clear future strategy, follow-up schedule, or diagnostic pipeline to manage the condition.
  • E - Evaluate: The provider judged the overall efficacy of current interventions, test results, or patient treatment responses.
  • R - Referral: The provider directed the patient to a specialist or external facility for targeted management

Whereas MDM stands for Medical Decision Making. In medical coding, it is the cornerstone of Evaluation and Management (E/M) coding, representing the cognitive effort a provider spends evaluating and treating a patient. This is abstract coding data of problems addressed, complexity added test or discussion with other providers and risk of mortality or morbidity of patient's illness and treatment options.

I hope I helped you understand better. Have a good day!:)
Lady T
 
It's a concept not a coding rule/guideline. It is mostly used in HCC/Risk Adjustment. It's a great concept and good framework to use to check dx coding though. If one of these is met, it most likely should be captured. However, the official guidelines are what you have to go by.
You would want to be careful doing it in an outpatient encounter.
This is from 2023 but read about what is said on MEAT and TAMPER here: https://ahima.org/media/oolfpens/create-practice-brief-template-final.pdf
 
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