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  1. #1
    Default Mdm
    Clearnace Sale
    In the MDM for the Number of Diagnosis: New problem (to examiner); add. workup planned field: Can I count this field if the patient is not a new patient, and the problem is not a new problem. I want to utilize the add workup planned, because the physician has ordered add work up before making his decision? Note: there is a semi colon in the description. Does that mean i can count 1 point in the Est. problem and 1 point for the add work up planned?????

    Please help,
    Kristen Richard, CPC

  2. #2
    Milwaukee WI
    Default No
    It's not a semi-colon, it's a colon. New problem (to examiner): add. workup planned. (emphasis added by FTB)

    It must be a new problem to get the 4 problem points.

    You can use the orderining of labs, x-rays or diagnostic tests to get data points. And check your table of risk, as well.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Default Mdm
    I'm sorry. I magnified the copy and it is indeed a semi colon. I do however agree with your input on the New prob. That is what I was thinking but wanted to verify with someone else. I have included the highmark audit E/M tool that I utilize. Let me know if you can view this document and magnify to see clearly that it is a semi colon.

    thank you,

    Kristen Richard, CPC

  4. #4
    It is a semicolon but I don't see how that makes a difference.

    The info after the semicolon is telling you what is required to support the info prior to it.

    There are 2 different values assigned to both new and established problems, the clauses after the semicolon describe what is necessary for that particular problem only, there is no mix and match.

    It would be nice if there was but unfortunately there isn't.

    Laura, CPC, CPMA, CEMC

  5. #5
    I agree. I was hoping that I could use those points for an established pt that is being seen as a follow up but the condition is getting worse and the physician has planned add work-up on that problem before he/she decides a plan (surgery). Instead I guess I am only able to count the Est problem; worsening...
    Oh well, I

    thank you for your help
    Kristen Richard, CPC

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