# Methotrexate



## RebeccaClendenen (Mar 11, 2009)

If a physician documents that the patient is getting better and that the Methotrexate is being continued?  (No changes, no new rx,) Would this constitute prescription drug management?  Or, since Methotrexate is a chemo drug, if you were to credit it, would you do so in the "Drug therapy requiring monitoring for toxicity"? There are differences of opinion. My thinking is if nothing is new or changed, it should not be credited at all, but I am curious to see what everyone else thinks


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## ARCPC9491 (Mar 11, 2009)

Well, nothing clearly defines what "prescription drug management" or "drug therapy requiring intensive monitoring for toxicity" REALLY mean. Nothing in the guidelines, nothing in the table of risk. There are MANY varying opinions and interpretations. Sometimes a decision to continue a medication might be considered "prescription drug management" since you would be managing the patient's rx medicine and since a decision to continue a patient's current medication may involve as much risk as a decision to initiate a rx drug regimen. On the flip side, sometimes it's not considered rx drug management if there are no changes, no new rx's. It's a matter of judgement by the provider and any reviewer.


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