Wiki New MDM

[Bjones83]

Hello I am trying to find clarification on the new MDM. I understand you have to have 2 out of 3 elements to assign, but what if I have a straightforward, limited and then moderate? How would I determine the level?

 

[csperoni]

https://www.ama-assn.org/system/files/2019-06/cpt-revised-mdm-grid.pdf

Level of MDM is based on 2 of 3 elements of MDM.

 

[Bjones83]

Thank you. I'm still trying to figure out what to do if I don't have 2 in the same level.

 

[twizzle]

If you need 2 out of 3 and have SF, Limited, Moderate then the overall level would be Limited/

 

[zcometa]

You take away the highest and the lowest. With your example you will be left with Limited MDM 99203/99213. You can think of it as Moderate MDM can meet the requirements for a Limited MDM but not the other way around. So, if you consider the Moderate MDM like a "Limited "+" MDM" then this gives you the 2 elements (Limited MDM and Limited "+" MDM) to determine your final MDM.

If you look at the AAPC audit tool in page 4 upper right: "Use any chart that meet or exceed". The "charts" are the three different elements for MDM. So, as I wrote above since Moderate MDM meets and exceeds a Limited MDM then you end up with a Limited MDM but since a Limited MDM does not meet or exceed a Moderate MDM then you can never end up with Moderate MDM in your scenario.

 

[Bjones83]

Ok thank you. I was overthinking it.