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Medical Decision Making (MDM) Calculator
Calculate E/M code level based on 2021 MDM guidelines. Determine complexity for office visits and consultations.
Patient Type
1. Number & Complexity of Problems
Select the highest level problem addressed at encounter
0 pts → Straightforward
2. Amount & Complexity of Data
Select all data reviewed, ordered, or analyzed
0 pts → Straightforward
Review of External Data
Ordering Tests
Independent Interpretation (Automatic 3+ points)
Discussion (Automatic 3+ points)
3. Risk of Complications
Select the highest level of risk from treatment decisions
Straightforward
Medical Decision Making Level
Straightforward
CPT: 99212
Problems
Straightforward
Data
Straightforward
Risk
Straightforward
MDM level = 2 of 3 elements (middle value)
E/M Level Reference
| Level | New | Est. | Problems | Data | Risk |
|---|---|---|---|---|---|
| Straightforward | 99202 | 99212 | Minimal (1 point) | Minimal or none | Minimal |
| Low | 99203 | 99213 | Low (2 points) | Limited (1 point) | Low |
| Moderate | 99204 | 99214 | Moderate (3 points) | Moderate (3 points) | Moderate |
| High | 99205 | 99215 | High (4+ points) | Extensive (4+ points) | High |
Billing Disclaimer
This calculator is for educational purposes only. Always verify coding with your billing department and follow your organization's guidelines. MDM is just one component of E/M level selection. Time-based coding may also be used when counseling/coordination dominates the visit.
About 2021 E/M Guidelines
Key Changes from 2021
- History and exam are no longer counted - only MDM or time
- MDM is based on 2 of 3 elements matching the level
- Time-based coding uses total time on date of encounter
- 99211 no longer requires physician presence
Documentation Tips
- Document specific problems addressed, not just diagnoses
- Note external records reviewed with source and relevance
- Document independent interpretation when done
- Record discussions with other providers
- State your assessment of risk explicitly
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