E/M Weekly Tip: Medical Decision-Making - Complexity

The levels of evaluation and management (E/M) services recognize four types of medical decision-making — straightforward, low complexity, moderate complexity and high complexity. Medical decision-making refers to the complexity of establishing a diagnosis and/or selecting a management option as measured by:
  • Number of possible diagnoses and/or the number of management options that must be considered
  • Amount and/or complexity of medical records, diagnostic tests and/or other information that must be obtained, reviewed and analyzed
  • Risk of significant complications, morbidity and/or mortality, as well as comorbidities, associated with the patient's presenting problem(s), the diagnostic procedure(s) and/or the possible management options
References

Contact Palmetto GBA JM Part B Medicare

Email Part B

Contact a specific JM Part B department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

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