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Rx management

wynonna

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Does a routine refill count under moderate on table of risk or does the provider have to change an Rx to count it towards Prescription Drug management?
thank you
 
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prescription drug management

Prescribing, modifying dosage and/or discontinuing the drug counts towards prescription drug management because this is managing. However, Renewing orders for an existing Rx or telling the patient to complete antibiotics does NOT count towards prescription drug management
 
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I recommend checking with the health plan you are billing. Most do not require that the physician change, start, or discontinue a medication but rather that the problem for which the medication was prescribed is assessed and the physician decides to continue, stop, change, etc.

"4. When can prescription drug management be credited in the Medical Making Risk of Complications chart?
Credit is given for prescription drug management when documentation indicates medical management of the prescription drug by the physician who is rendering the service. Medical management includes a new drug being prescribed, a change to an existing prescription or simply refilling a current medication. The drug and dosage should be documented as well as the drug management.
If medications are just listed in patient’s medical record, credit is given for past history." https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00005056 (See MDM section)

"What constitutes prescription drug management?
Q. During an evaluation and management visit, what constitutes “prescription drug management?”
A. “Prescription drug management” is based on documented evidence that the provider has evaluated medications as part of a service, in relation to the patient. This may be a prescription being written or discontinued, or a decision to maintain a current medication/dosage.
Note: Simply listing current medications is not considered “prescription drug management." https://medicare.fcso.com/FAQs/Answers/0324049.asp
 
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