Results 1 to 5 of 5

MDM established problem (to examiner)

  1. #1
    Default MDM established problem (to examiner)
    Medical Coding Books
    If a patient sees Dr A on Monday for knee pain, and then follows up with Dr. B due to worsening pain(both in the same practice), is this considered a new problem or an established problem? I believe that MDM states new problem to examiner.....

  2. Default it helps you
    Problems are defined relative to the examiner, not the patient. Even if the problem was previously known to other physicians or to the patient, it is still considered new to you if you are seeing the patient for the first time. This situation arises often in the case on consultations

    contact :

  3. Default
    Is it still a new problem for physicians in same practice?

  4. #4
    I totally agree, I spoke to a group of physicians yesterday and explained that an establised patient is not the same as an established problem. I also explained the Dr. B would have the same amount of work for a worsening problem because they have not yet addressed this problem themselves. They must go through the work of determining the plan etc. Also have an answer to the question from WPS on this that agrees with us both. Thanks for your input.

  5. #5
    Milwaukee WI
    Default Payer specific
    Please be sure to get the specifics from your payer. Per at least one Medicare carrier defines an established problem as established to the patient.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. New problem to the examiner
    By acward in forum E/M
    Replies: 23
    Last Post: 09-12-2016, 09:26 AM
  2. MDM points: established problem, worsening...
    By amexnikki23 in forum E/M
    Replies: 7
    Last Post: 08-25-2015, 02:03 PM
  3. New problem to examiner?
    By AmandaW in forum Emergency Department
    Replies: 3
    Last Post: 04-07-2015, 10:27 AM
  4. New problem or estblished problem to examiner
    By PKellogg in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 03-28-2011, 01:18 PM
  5. New problem to examiner
    By WEBBSURFN in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 10-08-2009, 09:50 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.