MDM Breakdown
Column counting problems
What is Number/Complexity of Problems?
Incident-To requires this setting
What is office/outpatient?
Includes provider non-face-to-face work
What is yes?
Diagnostic eval without medical services
What is 90791?
Stable HTN, med refill
What is Low MDM?
Column including tests/orders
What is Data?
Physician must be here for Incident To
What is physically present in office suite?
Not included in E/M time
What is clinical staff time?
Diagnostic eval with medical services
What is 90792?
Severe exacerbation COPD
What is High MDM?
Column with complication risk
What is Risk?
Split/shared billing modifier
What is -FS?
99215 typical time
What is 40 minutes?
Psychotherapy 60 min
What is 90837?
Two stable chronic conditions
What is Moderate MDM?
Moderate MDM example
What is acute illness with systemic symptoms?
Determines billing provider in split/shared
What is substantive portion?
Counts toward time (example)
What is reviewing records?
Must include in psychotherapy documentation
What is time, modality, progress?
Minor cold visit
What is Straightforward MDM?
High MDM example
What is threat to life or bodily function?
New problem in Incident To means
What is bill under treating provider?
Not counted toward time
What is separately reported services?
Group therapy CPT
What is 90853?
Undiagnosed problem w/ uncertain prognosis
What is Moderate MDM?