2022 Gastroenterology Reimbursement and Coding Update: Concrete Solutions to Strengthen Your Foundation in GI Coding and Billing | November 2021-03 - E&M 2021 Rev Pt 2 - Risks and Patient Management

03 - E&M 2021 Rev Pt 2 - Risks and Patient Management - Vaughn

Pdf Summary

This document provides an overview of the 2021 E&M Risk Table and the risks associated with complications and morbidity of patient management. It discusses the different levels of risk, including straightforward, low, moderate, and high, and provides examples for each level.<br /><br />The document also addresses a polling question regarding whether a patient would receive credit for moderate risk MDM "prescription drug management" if the provider documents "continue PPI therapy" in the plan of care. The correct answer is B. No, the provider must document the name and dosage of the prescription.<br /><br />It covers the definitions and criteria for risk in the context of medical decision making, including the assessment of the level of risk based on the nature of the event under consideration. It also explains that risk factors can include social determinants of health, drug therapy requiring intensive monitoring for toxicity, and surgery.<br /><br />The document specifically discusses the risk associated with endoscopy procedures, including minor and major surgeries, elective or emergency procedures, and risk factors relevant to the patient and procedure.<br /><br />Finally, it provides medical decision-making tips and answers common questions regarding the calculation of risk and the documentation requirements, including the consideration of external providers, the definition of chronic, stable conditions, and the inclusion of intensive monitoring for toxicity. It clarifies that the review of systems (ROS) is not a requirement for the new office E&M guidelines, but the history and physical exam must be pertinent to the chief complaint.<br /><br />Overall, this document serves as a guide for understanding the risks involved in patient management and how they contribute to medical decision making for E&M coding.

Keywords

2021 E&M Risk Table

complications and morbidity

patient management

levels of risk

MDM

prescription drug management

risk factors

endoscopy procedures

medical decision making

E&M coding