What score is assigned to established stable or improving conditions?

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In the context of Evaluation and Management coding, particularly under the new guidelines that emphasize the use of medical decision-making (MDM) for coding encounters, scoring of the complexity of the patient’s condition is crucial. For established patients, who have stable or improving conditions, the guideline assigns one point. This scoring reflects the lower complexity involved in managing stable or improving conditions compared to more complex or unstable ones.

Stable or improving established conditions indicate that the patient is not experiencing any significant change in their medical status, making the management straightforward. Therefore, a lower point value accurately represents the reduced level of decision-making complexity and risk involved in addressing these types of cases. This approach allows coders to assess the MDM accurately and assign the appropriate level of service when billing for evaluation and management services.

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