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As a consultant, you have just been hired by a new pulmonary physician practice

ID: 239465 • Letter: A

Question

As a consultant, you have just been hired by a new pulmonary physician practice to build a database to track their patients. There are four physicians within the practice which treat multiple pulmonary conditions. They collect complete demographic information from each patient. Because they are a new office, they are only seeing new patients at this time and use just five billing codes (99201, 99202, 99203, 99204, and 99205).

Create a one-to-many, a one-to-one, and a many-to-many relationship diagram (Note: three different diagrams are needed) that would be appropriate in this setting.

Explanation / Answer

One to many relationship diagram

New patient visit

To hospital

Doctor meeting

History taking and examination

Problem focused

Application of CPT codes

Doctor examination

Expanded problem focused

Detailed examination

Comprehensive examination

Medical decisionmaking

(complexity)

Doctor decision maker

Contributory factors

Presenting problem (severity)

Self – limited or minor

99201

Observed by the physician

Low- moderate

99202

Moderate

99203

Moderate to high

99204 and 99205

Counseling

Coordination of care

Face to face time

10

99201

Decide by the physician

20

99202

30

99203

45

99204

60

99205

One to one relationship diagram

New patient visit

To hospital

Doctor meeting

History taking and examination

Problem focused

Application of CPT codes

Allocated Doctor

1.examination

2. decision maker

3. Observation

Expanded problem focused

Detailed examination

Comprehensive examination

Medical decisionmaking

(complexity)

Contributory factors

Presenting problem (severity)

Self – limited or minor

99201

Low- moderate

99202

Moderate

99203

Moderate to high

99204 and 99205

Counseling

Coordination of care

Face to face time

10

99201

20

99202

30

99203

45

99204

60

99205

Many to many relationship diagram

Group of

New patient visit

To hospital

Doctor meeting

History taking and examination

Problem focused

Application of CPT codes

Group of doctors and other health care professionals

Expanded problem focused

Detailed examination

Comprehensive examination

Medical decisionmaking

(complexity)

Contributory factors

Presenting problem (severity)

Self – limited or minor

99201

Low- moderate

99202

Moderate

99203

Moderate to high

99204 and 99205

Counseling

Coordination of care

Face to face time

10

99201

20

99202

30

99203

45

99204

60

99205

One to many relationship diagram

New patient visit

To hospital

Doctor meeting

History taking and examination

Problem focused

Application of CPT codes

Doctor examination

Expanded problem focused

Detailed examination

Comprehensive examination

Medical decisionmaking

(complexity)

  • Straightforward
  • Low
  • Moderate
  • High
  • 99201,99202
  • 99203
  • 99204
  • 99205

Doctor decision maker

Contributory factors

Presenting problem (severity)

Self – limited or minor

99201

Observed by the physician

Low- moderate

99202

Moderate

99203

Moderate to high

99204 and 99205

Counseling

Coordination of care

Face to face time

10

99201

Decide by the physician

20

99202

30

99203

45

99204

60

99205

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