# Prescription Drug Management - charts to determine the MDM



## cpclori (Aug 17, 2012)

Looking for advice on this:
I have a provider who has told me when he is recommending a patient take OTC meds at prescription strength (such as Ibuprofen) he is considering this to be Moderate: Prescription drug managment for managment options. 

When I am looking at these charts to determine the MDM ( # dx, Amount of Data, and Risk ) I look at this as Low: OTC drugs for the management options.

How would this be viewed in an audit? I have not been able to locate any specific documentation on this and want to make sure we are coding the right way.

Any input would be appreciated-Lori


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## kevbshields (Aug 17, 2012)

Of course, there are two trains of thought with this.  Keep in mind that if it is an over-the-counter drug, then that is the way it would be captured for the MDM.  No prescription or order is required, thus it is OTC.

I'm sure others might have an opinion, but that is mine.


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## LLovett (Aug 17, 2012)

*I'm on the other train apparently...*

If the provider states to take an OTC at prescription strength then it is prescription drug management.

Example Ibuprofen 600 or 800. Either of those dosages requires a prescription, therefore no question it is prescription drug management.

It is cheaper for me to buy regular 200 tablets and take 3 or 4 of them depending on how the doctor directed me. The pharmacy advised me to get the OTC variety instead of having them fill it.

Obviously anyone can pick up any OTC and take as much as they want. If they have an adverse affect it is their own fault. If it is documented that a provider advised them to take an OTC at a dosage/increment not recommended on the label the provider is now liable if there is an adverse affect. 

Now I have had providers that state anytime they write anything on a script pad it is prescription management, even if it is for "rest". I of course disagree with this thought process. 

Just my take on it,

Laura, CPC, CPMA, CEMC


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## cpclori (Aug 18, 2012)

*Prescription Drug Management*

Interesting point of view on both sides. The provider said he is doing this as a cost saving measure for the patient. Perhaps I should suggest he write on a prescription pad to take the OTC Ibuprofen at prescription strength to cover this. That might be the best way to handle this issue. 
Any others have  comments?

Thanks! Lori


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