Lacy Hudgens
New
I have a couple of Rheumatolgiest that see alot of RA patients. When they come in for a follow up they are wanting to bill level fours. If the patient is in stable condition and nothing is being changed with thier meds I don't agree that a level four would be appropriate.
However if a patient comes in and thier RA is worseing and they are having to make changes to thier meds I can understand. When we are auditing thier visits though it is our policy to make medical decision making one of the two components to drive the E/M level. Since it is only one problem worsing and they change a med and run a lab we are only getting a low complexiaty for the MDM. The Rheumatolgiest do not agree with this stating that when looking at the bell curves the national average is mostly level fours and that thier patients are a higher complexity.
Has anybody else ran into this issue and what have you done?
However if a patient comes in and thier RA is worseing and they are having to make changes to thier meds I can understand. When we are auditing thier visits though it is our policy to make medical decision making one of the two components to drive the E/M level. Since it is only one problem worsing and they change a med and run a lab we are only getting a low complexiaty for the MDM. The Rheumatolgiest do not agree with this stating that when looking at the bell curves the national average is mostly level fours and that thier patients are a higher complexity.
Has anybody else ran into this issue and what have you done?