Risk

 The third part of the overall Medical decision The third part of the overall overall Medical Medical decision decision Making 

 The Risk Table is an official part of CMS Documentation Guidelines 

 Is scored independently 

 Along with Management Options and Amount and  Complexity of Data 

 Highest level of risk in any category determines the overall risk score

Nature of Presenting Problem

 99281 Usually, the presenting problems are self limited or minor 

 99282 Usually, the presenting problem(s) are of problem(s) are of low to moderate to moderate  severity 

 99283 Usually, the presenting problem(s) are of problem(s) are of moderate severity moderate severity.

 99284 Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician but do not by the physician physician but do not pose an immediate significant threat to life or physiologic function. 

 99285 Usually, the presenting problem(s) are of high severity and pose an immediate 18 are of high severity and pose an immediate immediate significant threat to life of physiologic function.

Level III: General comments 

 Moderate presenting problem but not Moderate Moderate presenting presenting problem problem but not requiring urgent evaluation 

 Prescription Drug Management 

 Includes Rx meds given in ED 

 Eye drops, ear drops, Antibiotics, pain meds 

 Limited diagnostic studies 

 Single X Single X-ray

 Systemic symptoms Systemic symptoms 

 Viral illness 

 Mild exacerbation of chronic condition

 Recurrent condition