tci E/M Coding Alert - 2021 Issue Q3

Reader Questions: Look to Criteria for Drug Therapy

Question: What qualifies as “drug therapy requiring monitoring” in the high-risk level of complications and/or morbidity or mortality of patient management element of medical decision making (MDM). Do patients who are continuing their treatment with no changes of meds or dosage qualify toward this level of MDM? Colorado Subscriber Answer: To qualify for that level of MDM, drug therapy needs to meet some criteria, per CPT® guidelines. First, “long-term intensive monitoring is not performed less than quarterly,” according to CPT®, However, there is no timeframe for this, as the guidelines also state that intensive monitoring may...

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