You can use new problem and not necessarily have added workup.
This all depends..is the patient new or established? After you have all the other elements to the audit, it may still only be a level 3. You have to consider the rest of the elements. He can have 3 points for new problem no added workup, but if the risk is low and he didnt review any work up, his MDM would only be a low anyways, even if his number of dx was a 3.
Would really have to see all the note to decide what LOS would have been appropriate. Self limiting problems are minor ones like bug bites,cold,etc. A new problem is any problem that the doctor or one in his group has never seen/treated before.
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