AMA CPT® Assistant - 2021 Issue 6 (June)
Frequently Asked Questions (June 2021)
June 2021 page 13 Frequently Asked Questions Evaluation and Management (E/M): Office or Other Outpatient Services Question: When there is an “undiagnosed new problem with uncertain prognosis” used to determine the number and complexity of problems addressed for medical decision making (MDM) level selection for all E/M office codes (99202-99205, 99212-99215), what is the level of severity needed for the problem to be considered or used as the data element of the MDM? This can be difficult to ascertain, especially when the physician or other qualified health care professional (QHP) does not list any differential diagnoses. For example, physicians...
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