For current Evaluation and Management (E/M) guidelines, does Medical Decision Making (MDM) need to be documented in a separate section or can it be included in the Assessment and Plan section?

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Last updated: February 5, 2026View editorial policy

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E/M Documentation: MDM Location Requirements

Medical Decision Making (MDM) does NOT need to be documented in a separate section from the Assessment and Plan—it can be fully integrated within the Assessment and Plan section. 1

Current E/M Guidelines on Documentation Format

The current E/M coding guidelines focus on what is documented, not where it appears in the note. 1, 2

Key Documentation Principles

  • No format requirements exist mandating MDM be separated from Assessment and Plan sections 1
  • Documentation should support the complexity of clinical decision-making regardless of where it appears in the medical record 1, 2
  • The American Academy of Family Physicians emphasizes that documentation should focus on supporting patient care and accurately retelling the patient's story, rather than meeting arbitrary format requirements 1

What Must Be Documented (Not Where)

For MDM complexity determination, you must document:

  • Number and complexity of problems addressed during the encounter 1
  • Amount and complexity of data reviewed, ordered, or analyzed 1
  • Risk of complications, morbidity, or mortality associated with the presenting problem(s), diagnostic procedures, and treatment options 1

Common Pitfall to Avoid

Do not create artificial separation between Assessment and Plan and MDM elements simply to satisfy a perceived documentation requirement. 1 This leads to redundant documentation that clutters the medical record without adding clinical value. 2

The American College of Physicians explicitly warns against documentation that includes boilerplate content to satisfy perceived guidelines rather than clinically relevant information. 1

Practical Implementation

Integrate MDM naturally within your Assessment and Plan by:

  • Documenting your diagnostic reasoning and differential considerations under each problem 2
  • Explicitly stating data reviewed (labs, imaging, records) and your interpretation 1
  • Noting the complexity of treatment decisions and risk discussions with patients 1, 2

When using time-based coding, document total time spent including non-face-to-face work on the same day. 1

References

Guideline

Accurate E&M Coding for Proper Reimbursement

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Optimizing Inpatient Clinical Documentation and Reimbursement

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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