The five different levels of the nature of the presenting problem offer a different view into the documented E/M service visit differently than the medical decision making. How does the nature of the presenting problem create a different insight into the E/M service?

What will be an ideal response?

Answers should include (but may not be limited to) the following:
? The presenting problem is the disease, traumatic injury, medical condition, illness, undefined symptom, undiagnosed complaint, or any other reason for the E/M service visit.
? The nature of the presenting problem represents an identification of the level of severity involved in the disease, traumatic injury, medical condition, illness, undefined symptom, or undiagnosed complaint.
? There are five different levels of presenting problem severity: minimal, self-limited or minor, low, moderate, and high. CPT correlates specific types of presenting problem with specific levels of E/M services.
? When the nature of the presenting problem, counseling, and coordination of care require that more than 50 percent of the E/M service visit be spent in providing counseling and/or coordination of care, time becomes the controlling factor in determining the level of the E/M service.
? Intraservice time is the amount of time the physician spends providing clinical, medical, or professional service during an E/M service

Health Professions

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