Wiki Risk table

[drtmod40]

If a pt comes in for a new problem and dx with sinusitis. The pt. has no co morbidity, no other complaints and no work up. The provider gave pt a rx. Would this fall under MODERATE on the risk table for rx management?? It's my understanding we are to go with the highest level circled on the table of risk. Correct??

 

[thomas7331]

Most payers and auditors that I've worked with consider this scenario (i.e. a single problem with prescription written and no other factors involved) to be low level MDM and would not allow an E&M to exceed a level 3. Simply writing a prescription does not really qualify as prescription drug 'management', and it's important to keep in mind that the guidelines state that the table of risk is only a guide and not an absolute measure of risk.

 

[drtmod40]

So with that being said would you say if there is other complaints such as fever, and/or co morbidity that would be Moderate Risk?

 

[drtmod40]

One more...what about lets say pt was dx with bronchitis not stating exacerbation and given steroids. Due to the risk of the drug and dx of bronchitis would you say this warrants a Mod. Risk of rx management?? BUT if pt was given antibiotic only you would go with Low on the risk??