Thank you, this is very helpful.MDM has 3 components, currently:
The past cancer would currently be an established problem (either stable, improving, or worsening depending on patient's state). There may be additional diagnoses being treated, and you could count those as well.
- # of diagnoses
Data - did you review or order labs, radiology, etc?
Risk - if currently NOD and no complaints, I would call that a stable chronic illness (level 3)
- if currently NOD and perhaps a mild complaint, I would call that a chronic illness with side effects (level 4)
- if currently experiencing signs of recurrence, I would call that a chronic illness that poses a threat to life or bodily function (level 5)
So, depending on other diagnoses, what is ordered/reviewed and the status of the patient, you could be level 2, 3, 4 or 5.
2021 rules will differ.
Thank you, this is very helpful.
Would you classify the monitoring of a past cancer as a chronic illness in 2021, or would you consider this to be a minor problem, assuming no recurrent cancer is documented?
I would count this differently depending on the exact circumstances (ie How past is past? Are you the physician monitoring the cancer for signs of recurrence? Or is it really just an element in their history?)If the patient presents as a new patient to your practice but has history of a past cancer, do you mark as chronic illness in MDM or can you count as a new diagnosis since they are a new patient to your practice?