Reader Questions: Don’t Use These MDM Tables Interchangeably

Why This Topic Matters

Understanding which MDM framework applies affects E/M code selection and helps avoid applying the wrong reference table to a service. The article is important because it clarifies how updated office/outpatient E/M guidance differs from older E/M leveling approaches used in other settings.

Article Sections

1. Question

   The reader asks about two medical decision-making reference tables and whether examples from one framework can be used for another set of E/M services.

2. Answer

   The response explains the relationship between the 2021 CPT® office/outpatient E/M revisions and the continuing CMS approach for other E/M services. It also describes the general nature of the clarification published in CPT®Assistant.

3. Example and comparison of risk concepts

   This section uses a broad surgery-related example to illustrate how the two tables present risk concepts differently in the context of MDM.

4. Summary of the revised MDM focus

   The closing discussion summarizes the shift in how MDM is framed for office/outpatient E/M services and ties that framework to broader treatment and management considerations.