E+M levels psych visits ED

Hello, I have difficulty coding high level presenting problem psych charts for the ED MD. Examples are psychosis + suicidal ideation. What should I be looking for in MDM? Section 12 and physical restraint lead me to a level 5. Often the ED MD is medically clearing the pt and minimally treating w/ p.o. meds after doing labs. How involved is the ED MD in transfering pt to a psych facility or admitting pt to the ED hospital's psych dept? Thanks,

re: E+M levels psych visits ED

MDM is only one component of three that must be satisfied. You can have moderate-high complexity but only document a lower level H&P.
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/eval_mgmt_serv_guide-ICN006764.pdf

re: E+M levels psych visits ED

You must meet or exceed 2 of the 3 Key Components

re: E+M levels psych visits ED

Thanks for your response. Let's say the rest of the E+M is comprehensive and the level depends on the MDM. MDM for psych visits is what I find difficult.

re: E+M levels psych visits ED

Well when you have a potential suicidal patient with deep depression, I would say the MDM is high complexity. Consider the risk of morbidity/mortality if this patient is not treated. There is so much to access for a psychotic or suicidal patient.