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Credentialing Glossary

MDM (Medical Decision Making)

medical-coding

Definition

The cognitive complexity element of E/M code selection (since 2021 office E/M revision). Three components: Number/Complexity of Problems Addressed, Amount/Complexity of Data Reviewed, Risk of Complications/Mortality. Two of three must meet the level (Straightforward, Low, Moderate, High). Moderate MDM (99214) requires only 2 of 3 elements at moderate level: a chronic illness with exacerbation OR an undiagnosed new problem with uncertain prognosis OR review of prior external notes plus tests OR drug therapy management.
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