Patient has 1 diagnosis either atopic dermatitis or psoriasis that is stable on date of service, with med refill. However, provider believes it should be a level 4 because she includes "waxing and waning" in the assessment. Don't we have to go by how the patient presents on the specific date of service? If patient has not gotten worse, stayed the same, or even improving, how can that fall under a level 4? Waxing and waning could apply to a lot of disease conditions.