One of our providers is seeing a new patient with several chronic conditions. He is managing three of these conditions (all problems new to him), however I am struggling with the Marshfield Clinic (MC) tool.

According to the MC tool, there is a Max=1 for New Problem without any additional workup done. Because the provider is managing several chronic conditions, it seems a bit unfair that he is getting penalized for the Max=1 and not able to get his 4 points in the Diagnosis and Management Options. I realize this might be where the MC tool is imperfect.

I can place one of the chronic conditions (fibromyalgia) in the New Problem without any additional workup, however I am puzzled as to where I can put the other 2 (chest pain, hypermobility). Since neither of the two problems are Established problems, I can’t really put them there; however both might be too severe to be categorized as a "Self Limited/Minor" problem?

Any help/guidance would be greatly appreciated!

Thanks!