Primary Care Coding Alert

Auditing:

Is the Problem New to a Partner's Patient?

You've hunted for new problem specifics; we've found the details for you.Your FP gets more medical decision making points for a new problem, but when his partner has already seen the patient for the problem, determining if the problem is still 'new' proves elusive. Here's the skinny on the rules you've got to follow before giving new problem credit.Capture More MDM Points Depending on Problem's StatusUnder Medical Decision Making Number of Diagnoses or Treatment Options, the standard audit worksheet gives 1 point for a stable or improved established problem and 2 points for an established problem that is worsening. But for a new problem, the physician gets a whooping 4 points when additional workup is planned and 3 points when no workup is planned. The problem has to be new to the examiner, according to the Highmark Medicare Services Documentation Worksheet (www.highmarkmedicareservices.com/partb/reference/pdf/scoresheets/8985.pdf).Catch: "Is the problem considered new when a [...]
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