# MDM established problem (to examiner)



## lverellen (Jul 20, 2011)

If a patient sees Dr A on Monday for knee pain, and then follows up with Dr. B due to worsening pain(both in the same practice), is this considered a new problem or an established problem?  I believe that MDM states new problem to examiner.....


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## nagarajs  (Jul 21, 2011)

*it helps you*

Problems are defined relative to the examiner, not the patient.  Even if the problem was previously known to other physicians or to the patient, it is still considered new to you if you are seeing the patient for the first time. This situation arises often in the case on consultations  

 contact : grand_pcs@yahoo.co.in


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## denpopa (Jul 21, 2011)

Is it still a new problem for physicians in same practice?


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## lverellen (Jul 21, 2011)

Najarags:
I totally agree, I spoke to a group of physicians yesterday and explained that an establised patient is not the same as an established _problem_.  I also explained the Dr. B would have the same amount of work for a worsening problem because they have not yet addressed this problem themselves.  They must go through the work of determining the plan etc.  Also have an answer to the question from WPS on this that agrees with us both.  Thanks for your input.
LBV


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## FTessaBartels (Jul 27, 2011)

*Payer specific*

Please be sure to get the specifics from your payer. Per emuniversity.com. at least one Medicare carrier defines an established problem as established to the *patient*.

F Tessa Bartels, CPC, CEMC


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