Related to medical decision making, it was discussed and understand that it was intended that

Related to medical decision making, it was discussed and understand that it was intended that physicians use their clinical judgement. The problem is, coders/auditors/coding educators are trying to use the tool for consistency. We need a way to insightfully apply the guidelines. Please elaborate on what constitutes Prescription Drug Management; is it enough to simply review a medication list, does there need to be management of the condition, etc? Also, does a provider stating "there is a moderate risk for an over-the-counter medication" enough to justify a moderate level of risk for patient management?

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CPT Knowledgebase - Nov 4, 2022