Wiki E/M Risk level

[wrightju1]

Where is a good place (or cheat sheet) to find info in determining the Risk Level for the Diagnostic Procedures ordered during an E/M service? In auditing Cardiology services this seems to be the toughest part in determining the Risk Level.

Any guidance out there?

 

[OCD_coder]

The Risk Table in the MDM section of the CMS 1995 Documentation Guidelines lays out the risk level for diagnostics in the center section of the table.

 

[wrightju1]

The Risk Table in the MDM section of the CMS 1995 Documentation Guidelines lays out the risk level for diagnostics in the center section of the table.

Right, but I'm looking for Cardiology tests specifically. What ones would be considered Low, Moderate or High Risk perhaps by CPT code.

 

[theresa.dix@tennova.com]

Right, but I'm looking for Cardiology tests specifically. What ones would be considered Low, Moderate or High Risk perhaps by CPT code.

Ive not ever seen one. But you should be able to use the MDM portion of the audit tool. Is there a particular procedure or test you want to know?

 

[wrightju1]

Ive not ever seen one. But you should be able to use the MDM portion of the audit tool. Is there a particular procedure or test you want to know?

There isn't a particular code I was wondering about. I guess I'm just wishful thinking that the professional organizations out there would get some of their specialty specific elements out of the gray areas. I was hoping there was some guidance as to "this code range is considered moderate risk, and this range is high risk". But I guess I'm out of luck. Thanks for the feed back though!