tci Medicare Compliance & Reimbursement - 2021 Issue Q2

Reader Questions: Review Guidelines on MDM and Medication Management

Question: One of our providers advised a patient to continue taking a given medication at the same dose. She did not prescribe any refills. Can this be counted toward medical decision making (MDM)? Kentucky Subscriber Answer: Prescription drug management is listed as an example of a moderate-level risk of morbidity from additional diagnostic testing or treatment under the risk of complications and/ or morbidity or mortality of patient management element of MDM, but CPT® currently has no guidelines to help you determine exactly what prescription drug management consists of. However, you can look to your particular Medicare contractor for...

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