My providers feel we are under coding many of their visits. They feel any visit where they prescribe medication can be considered Moderate Risk. So if a child comes in with an OM and they prescribe medicine, it can be considered moderate MDM making it much easier to reach that level 4: Dx/Treatment 3 points New Problem with no add’l W/up & moderate risk for prescribed medicine. Giving them 2 of 3 MDM requirements. I am concerned that if every OM starts being billed as a level 14, it will throw up a red flag to insurance companies for overcoding. Granted I do not want them losing out on revenue deserved, just don’t feel every OM should be considered level 14. I feel they need to take on a case by case issue. If there is fever involved or other modifying factors. Am I over thinking this? When I think about prescription drug management, I don’t think of antibiotics for ear infection. I get it that MDM can be very subjective and there is no real clarity on what cms wants.
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