decisionhealth Newsletters, Part B News - 2020 Issue 11 (November)
The three elements of MDM: Examine the levels of ‘problems addressed’
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Article Overview
This article is part of a series on the 2021 office visit E/M guidelines and focuses on the medical decision-making component tied to problems addressed. It is aimed at coders and billing professionals preparing for office visit code selection changes and explains the broad categories of problem severity, how the concept of an addressed problem is framed, and how common clinical scenarios are grouped for general guidance.
Why This Topic Matters
Understanding the problem-oriented MDM element helps coding professionals assess office visit level under the revised 2021 E/M framework and see how the updated structure affects documentation review and code selection.
Article Sections
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2021 E/M office visits
Introduces the 2021 office visit guideline context and the broader MDM framework being discussed for evaluation and management services.
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Defining ‘problems addressed’
Explains the general concept of a problem in the encounter and describes the broad idea of when a problem is considered addressed under the guidelines.
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A closer look at the 4 levels of problems addressed
Outlines the general severity tiers for problems addressed and summarizes the types of clinical situations discussed within those tiers.
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Consider these examples
Provides illustrative encounter scenarios showing how different problem types are discussed in relation to office visit selection.
What You Will Learn
- How the 2021 office visit MDM framework is organized
- What is meant by a problem being addressed in an encounter
- How the article groups common problems into severity levels
- What kinds of scenarios are used to illustrate the framework
Who Should Read This
- Medical coders
- Coding educators
- Billing and reimbursement staff
- Clinical documentation improvement staff
Codes Discussed
Code Ranges Discussed
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