Quaker
Networker
I need some help determining the medical decision making portion of a TCM service. An initial contact within 2 days is made to the patient and the patient is scheduled to follow-up with the PCP 5 days post acute care discharge s/p a severe allergic reaction (swelling face, throat, rash all over) to a chemical at work. The pt presents for the 5 day face-to-face visit. He still has some mild complaints but is doing well and the provider tapers his steroids (Rx started in hospital) and refers him to an allergist. I assume that I can give 4 points for a new problem to PCP with add'l workup. Let's say the data reviewed = 3 pts for reviewing D/C paperwork & diagnostic testing. Now what about the table of risk? The provider feels that since this pt had a severe reaction to a chemical that the presenting problem would fall into the high severity risk for his visit however; I'm thinking not because the patient is now stable at discharge and would fall into the moderate complexity (acute illness w/ systemic symptoms since he still have some minor complaints) and Rx mgmt. I'm having a hard time determining where conditions would fall under the table of risk in the presenting problem area post acute care discharge when billing TCM codes. Please help!!