Maybe I am naive here....
but for many visits, doesn't the nature of the presenting problem or the diagnosis take care of medical necessity by bumping down the MDM level, thereby lowering the overall code assigned? Brandi's statement of not assigning a 99215 to a cold is absolutely correct. But unless the doctor is documenting the patient's history since 1927, and examining every part of her body, how would you get 99215? How would this diagnosis possibly even get close to a high level of MDM? You couldn't get 4 points on nature of the presenting problem, it can't be a high level of risk, and could you really get 4 data points? Realistically, I don't see how it would happen, even if you copy and pasted every visit the patient ever did.
I understand Brandi's point, and I concurr with the meaning of the statement, but I just can't see it in the real world. Now, if you say that these kinds of actions can result in overuse of 99214 with colds, then I say that is a stronger possibility and more of a problem that can arise.
Lance Smith, MPA, COC, CPMA, CEMC, RHIT, CCS-P, CHC, CHPC
Ellenville, NY Local Chapter