tci E/M Coding Alert - 2023 Issue Q2

Reader Questions: Look to Medicare for MDM Advice on Rx Management

Question: What qualifies as prescription drug management, which is a moderate-risk level in the 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? Vermont Subscriber Answer: CPT® currently has no guidelines for this. However, you can get a sense of how MDM for this element plays out by looking to Medicare’s directions for prescription drug management. According to Novitas Solutions, a Part A/B Medicare Administrative Contractor (MAC), you can get MDM credit for...

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