Wiki Work up - opinion please

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Our auditing team has multiple opinions on the following issue:

Infectious Disease provider is consulting for possible infection and treatment. They are awaiting biopsy results ordered and completed by the dermatology department. Do you consider this a new problem with work up for the ID provider since he/she needs the results of the biopsy to make the final treatment recommendations?

We appreciate your opinion!
 
I would say no. Workup, from the perspective of an auditor, means any diagnostics that have been performed or planned in order to get a clear picture of the nature of the presenting problem by the rendering provider. The decision to do so had already been made by the dermatologist. But, that fact doesn't mean that there isn't some benefit to his uncertainty about the patient's condition. The fact that he's awaiting information from dermatology means that he would be treating an undiagnosed new problem with uncertain prognosis, which is moderate risk.

I'd give credit for a new problem, but moderate risk (on the table) for the uncertain prognosis.
 
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