Wiki Prescription drug management

[tsm]

I know prescription drug management is listed on the audit form for moderate complexity, but would it ever be used for low complexity? Example: Patient is being treated for scabies infestation, the patient returns with a complaint that it is not getting any better. Pt. indicates that her child also seems have it. The doctor gives another script for the same drug at the same strength but also prescribes enough for the child. This is the only problem addressed at this session. Would this be considered a chronic problem? Would the prescription for the medication be enough to make this a 99213? When I use the 95/97 audit form I get a 99212--low complexity. The audit form does not indicate prescription drug management, but only over the counter drug management.

 

[MnTwins29]

Seems to be moderate complexity

IMO, this would still be moderate complexity. I am assuming that only the patient, not her child, is being treated at this visit. If so, the physician assessed the treatment thus far with the medication and made an adjustment based on the new information that the patient's child may have it. Again, IMO, but this seems to be a documented adjustment of the prescription medication - so not sure why it would be considered low complexity.

 

[DCOMPauditor]

Moderate Complexity

I have to agree with MnTwins, prescription drug management should still be considered mederate complexity, but you also have to take into consideration the amount of data that the provider reviewed/ordered as well as diagnostic testing to determine the overall MDM level. Hope this helps!

 

[mlbaker1974]

Depending on the contract with the payer prescription drug management CAN be broken down into two categories 1) prescription drug maintenance (refill of current medications) can be considered low risk and 2) prescription drug management (new drug to patient or drug that requires regular but not intensive monitoring for toxicity) can be considered moderate risk. Again it depends on what is in the contract with the payer and I would advise that some research be done regarding the contracts to see if this applies to your practice.

Hope this helps