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est patient/2 of 3 components

  1. #1
    Exclamation est patient/2 of 3 components
    Medical Coding Books
    I know that established patients only need two out of three components to meet a level. But if the history and PE are detailed, but the MDM does not meet a level 4, can I pull this down to a level 3?? any help is appreciated!

  2. #2
    It can be 4, or it can be 3, or even 2 – it will depend on medical necessity. Sometimes it is difficult for a coder to decide, but table of risk gives you at least an idea what medical necessity should be.
    I hope it helps.


    Sofia MS, CPC

  3. #3
    thank you, I figured that depending on medical necessity, at the highest it could be 4, but can technically be any level below that. Thank you for your help.

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