Cracking the Code
2021 Revised E/M Guidelines for Medical Decision Making (MDM)
When coding professional evaluation and management (E/M) cases for office and other outpatient visits (CPT code range 99202-99205; 99212-99215), it is important to understand the revised 2021 guidelines for medical decision making (MDM).
Rationale: low number and complexity of problems being addressed with acute, uncomplicated illness; moderate amount of data to be reviewed and analyzed with independent interpretation of prior x-ray performed at an outside facility; lastly, moderate risk of complication with prescription drug management. Based on 2/3 for MDM elements, this would constitute as a level 4 visit.