Number of diagnoses or Treatment Options

I have been auditing for a loooong time but I have never really understood how to apply "treatment options" in table A of medical decision making.

It seems that table A is primarily if the patient is stable or worsening and if the problem is new whether or not workup is planned.

What if you have an established problem, precocious puberty that has treatment options-implant vs oral meds or asthma that has a lot of treatment options.

You do not get to count those options, only if the problem is either stable or worsening. Is there a way to count treatment options? The table says "Number of Diagnoses or Treatment Options"

Usually I just count number of diagnosis but recently I had an endocrinologist want to count treatment options and I didn't know what to say.

Thank You,
Louise

treatment options E/M

It is generally understood this means "options", example: surgery vs medical treatment. The physician must consider the benefits or risks for each option in the medical decision making process.
Another example: radiation vs chemo or a combination of both.

treatment options

I agree with your interpretation. For MDM, number of treatment options/diagnoses, one problem addressed is either stable or not in good control/worsening. Additional work up for a worsening problem doesn't get you any additional "points" in the audit system we all use. The original Guidelines don't have these points, and maybe were intended to allow credit for that, but all most all of the payers use the point system.

I would tell the doctor that treatment options are part of the table of risk.

Endocrinology Treatment Options

Why wouldn't the Endocrinologist be able to have treatment options counted? Is it any easier to discuss with a patient chemo vs radiation than to discuss statin therapy vs behavioral modification. It takes a long time for all specialties to discuss treatment options. How do we get primary care and endocrinology providers paid for their cognitive thought progess when it doesn't meet the time counseling requirement. For properly each patient with diabetes, HbA1c, blood pressure and lipid management are addressed at each visit, in addition to other components such as kidney function, eye exams, peripheral extremity exams, etc. Is there an easier way to document to include all the thought processes without dictating an entire page on each patient? We are on an EMR and templates seem to be difficult to customize enough to address all the issues at each visit and document quickly all that has transpired at each visit.