1
,2
, 6. Discuss how specificity, sensitivity & predictive value contribute to the usefulness
of the diagnostic data
-Specificity of a test, we are referring to the ability of the test to correctly detect a specific
condition.
-Predictive value is the likelihood that the patient actually has the condition and is, in part,
dependent upon the prevalence of the condition in the population.
-When a test is very sensitive, we mean it has few false negatives.
7. Discuss the elements that need to be considered when developing a plan
Acknowledge the list
-Negotiate what to cover
-Be Honest
-Make a follow-up
8. Describe the components of Medical Decision Making in E&M coding
- There are three key components that determine risk-based E&M codes.
-History
-Physical
-Medical Decision Making (MDM) E&M coding requires a medical decision
maker
-Medical decision making is another way of quantifying the complexity of the thinking that is
required for the visit.
-Complexity of a visit is based on three criteria:
-Risk
-Data
-Diagnosis
3
, -Now, medical decision making is a special category. Why is this so important? Well,
the MDM score gives us credit for the excess work involved in management of a more complex
patient.
9. Correctly order the E&M office visit codes based on complexity from least to most
complex
99212 - 99214
10. Discuss a minimum of three purposes of the written history and physical in relation
to the importance of documentation
-It is an important reference document that gives concise information about a patient's
history and exam findings.
-It outlines a plan for addressing the issues that prompted the visit. This information
should be presented in a logical fashion that prominently features all data immediately
relevant to the patient's condition.
-It is a means of communicating information to all providers who are involved in the
care of a particular patient.
-It is an important medical-legal document
-It is essential in order to accurately code and bill for services.
11. Accurately document why every procedure code must have a corresponding
diagnosis code
-Every procedure code needs a diagnosis to explain the necessity whether the code represents an
actual procedure performed or a nonprocedural encounter like an office visit.
4
,2
, 6. Discuss how specificity, sensitivity & predictive value contribute to the usefulness
of the diagnostic data
-Specificity of a test, we are referring to the ability of the test to correctly detect a specific
condition.
-Predictive value is the likelihood that the patient actually has the condition and is, in part,
dependent upon the prevalence of the condition in the population.
-When a test is very sensitive, we mean it has few false negatives.
7. Discuss the elements that need to be considered when developing a plan
Acknowledge the list
-Negotiate what to cover
-Be Honest
-Make a follow-up
8. Describe the components of Medical Decision Making in E&M coding
- There are three key components that determine risk-based E&M codes.
-History
-Physical
-Medical Decision Making (MDM) E&M coding requires a medical decision
maker
-Medical decision making is another way of quantifying the complexity of the thinking that is
required for the visit.
-Complexity of a visit is based on three criteria:
-Risk
-Data
-Diagnosis
3
, -Now, medical decision making is a special category. Why is this so important? Well,
the MDM score gives us credit for the excess work involved in management of a more complex
patient.
9. Correctly order the E&M office visit codes based on complexity from least to most
complex
99212 - 99214
10. Discuss a minimum of three purposes of the written history and physical in relation
to the importance of documentation
-It is an important reference document that gives concise information about a patient's
history and exam findings.
-It outlines a plan for addressing the issues that prompted the visit. This information
should be presented in a logical fashion that prominently features all data immediately
relevant to the patient's condition.
-It is a means of communicating information to all providers who are involved in the
care of a particular patient.
-It is an important medical-legal document
-It is essential in order to accurately code and bill for services.
11. Accurately document why every procedure code must have a corresponding
diagnosis code
-Every procedure code needs a diagnosis to explain the necessity whether the code represents an
actual procedure performed or a nonprocedural encounter like an office visit.
4
