yet another coding question

[Guest guest]

" " The sticky point is the part about writing for a prescription medication. Your coder is correct that the entry " prescription drug management " is listed in the " moderate " section. But using this to determine the level of risk is interpreting the table somewhat mechanically, seemingly without a good grasp of medical necessity. "

The above is from this article which also says

" The mere presence of prescription drugs does not necessarily qualify for moderate complexity. CMS has indicated that writing a prescription for a seven- or 10-day supply of an antibiotic is not considered to be a moderate level of complexity. At least one Blue Cross company has indicated that prescription drug management involves more than the use of prescription drugs. It may mean a change in regimen, the addition of an agent, or the worsening of a problem. In other words, any prescription is not a guarantee that a payer will see this your way. "

http://www.physicianspractice.com/coding/content/article/1462168/1769459?CID=rss

very very kafkaesque...

-- Sangeetha Murthy M.D7830 mont Mesa Blvd #287San Diego, CA 92111www.mypcponline.com