Medical Decision Making

Medical Decision Making and Quantifying Your Cognitive Labor

This is arguably the most important of the three key components because the Medical Decision-Making ( MDM ) reflects the intensity of the cognitive labor performed by the physician. The official rules for interpreting the MDM are identical for both the 1995 and 1997 E/M guidelines.

There are four levels of MDM of incrementally increasing complexity:

Straightforward
Low Complexity
Moderate Complexity
High Complexity

Physicians must stratify the MDM into one of the above levels of complexity based on:

The nature and number of clinical problems
The amount and complexity of the data reviewed by the physician
The risk of morbidity and mortality to the patient.

The overall level of Medical Decision-Making is determined by referring to the following table:

Number of diagnoses or management options	Amount and/or complexity of data to be reviewed	Risk of complications and/or morbidity or mortality	Level of Complexity of Medical Decision-Making
Minimal	Minimal or None	Minimal	STRAIGHTFORWARD
Limited	Limited	Low	LOW COMPLEXITY
Multiple	Moderate	Moderate	MODERATE COMPLEXITY
Extensive	Extensive	High	HIGH COMPLEXITY