Are you talking about admit codes 99222 and 99223?
I always compare them to 4s and 5s for consults/new patients and the only difference is the MDM goes from moderate to high.
It is hard to give an example because MDM is 2 of 3 so the exact same patient with the same problem could be moderate for one provider and high for another based on data points alone.
You could have a patient being admitted for pnuemonia and they have HTN. By itself this is going to fall under moderate risk with 4+ dx points. The difference is in the data in this case.
If the provider orders xrays, labs and an ekg that is 3 points, still moderate MDM.
If the provider orders xrays, labs and does an ekg w/interp this is now 4 points and will put this up to high MDM.
I don't know if this the type of example you are looking for but this is what comes to my mind first on a scenario that could go either way.
Laura, CPC, CEMC
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