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Documentation Guidelines for Proper Medical Decision Making
The Medical Decision Making (MDM) of an evaluation and management (E/M) visit is one of the three components of determining the level of a patient’s visit. But the MDM can sometimes be the most difficult component, as this is where the provider’s thought process is quantified in deciding the correct level of E/M service. In the…
Elements of Medical Decision Making for Rheumatologists When Coding and Billing
What rheumatologists need to know about determining the level of medical decision making (MDM) for an office visit
Breaking Down Medical Decision Making
The medical decision making (MDM) of an evaluation and management visit is just one part of a patient’s visit. Rheumatologists can make the mistake of thinking that the level of visit can be determined just by the MDM, but that is often not the case.
A New Era of Coding Evaluation & Management Services
After 25 years, the American Medical Association (AMA) Current Procedural Terminology (CPT) office and outpatient evaluation and management (E/M) codes received a major overhaul. These changes, which went into effect Jan. 1, will help reduce administrative burden on providers and roll back some of the rigid requirements for E/M coding by simplifying the code selection…