Wiki Prescription Drug Management

[mtoups720]

I am struggling with what qualifies for this - for example, I am coding ED encounters and the provider will prescribe ibuprofen. Does this count as prescription drug management because it is a prescription? Or would it count as OTC medications?
Any thoughts, articles, reasoning is greatly appreciated!

 

[twizzle]

To some extent it would depend on the dosage prescribed. Ibuprofen is, of course, available OTC but higher strengths (400 thru 800 mg) are prescription strength, not available OTC, and would usually qualify as Rx drug management and moderate risk MDM. OTC (100 and 200 mg) would generally be low risk MDM.

It's a fine line between OTC and Rx drug management if, for example, a provider tells the patient to buy some Ibuprofen 200mg but to take 2x200mg doses four times a day - decision as to whether this is low or moderate risk would depend on the medical necessity of the higher dosage and the documentation. For example, does the patient have a mild ankle sprain or do they have exacerbation of osteoarthritis of the knee which has become acutely painful and for which a higher dose is required?

As ever, it comes down to documentation and medical necessity.

 

[mtoups720]

That helps so much - I appreciate your response, thank you!