Wiki Nursing Home Medical Decision Making

KLRuhe

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I have a question for an E/M expert regarding 99306 Initial Nursing Facility Care. This code requires medical decision making of high complexity. That is the component that my question is in regard to:

The following examples are patients that the physician is admitting from the hospital to the nursing facility. The physician reviews multiple records from the hospital stay (labs, x-rays, medicine changes, etc.) So, the "Data" component of medical decision making would be met, in my opinion.

#1. The patient is on multiple medications for several chronic, but stable, conditions (senile dementia, status post hip fracture repair - doing well, hypertension -stable, GERD, RAD -stable).

#2. The patient is on multiple medications for several chronic conditions again, but this patient's diagnoses are severe senile dementia, recent acute gastroenteritis -resolved, chronic renal insufficiency, poor oral caloric intake.

I am unsure if either of the above would meet the definition of "high" medical decision making.
 
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