Medicare Compliance & Reimbursement - 2015 Issue 1
Key Elements: Practice the Marshfield System for Figuring MDM
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Article Overview
This article walks through a point-based method for evaluating medical decision making (MDM) in an outpatient-style scenario. It is aimed at coding and documentation readers who want to understand how the three MDM components are assessed at a high level using a practical example and general point categories.
Why This Topic Matters
MDM level affects evaluation and management documentation review, so understanding how the components are organized helps readers interpret visits consistently and compare records to coding guidance.
What You Will Learn
- How the Marshfield point-based approach organizes the three components of medical decision making.
- How documentation elements are grouped into broad levels of complexity for MDM review.
- How a practical clinical scenario can be used to illustrate the relationship among diagnosis/treatment options, data reviewed or ordered, and risk.
- How the final MDM level is determined at a high level from the component assessment.
Who Should Read This
- Medical coders
- Clinical documentation specialists
- Auditors
- Physician office staff
- Billing and compliance professionals
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