DecisionHealth, DecisionHealth - 2024 Issue 4 (April)

Q&A: When counting unique tests for E/M visits, look to the CPT codes

Question: We have heard conflicting information regarding the way we count data to be reviewed and analyzed for E/M visits coded using medical decisionmaking. In particular, when counting unique tests, we have been told that when our provider reviews test results on a hospital patient chart for a complete blood count (CBC), basic metabolic panel (BMP), international normalized ratio (INR), and X-ray, that they can only count those as one unique test because they are all being pulled from one source – the hospital’s patient chart. Our read is that in the definition of a unique test, the E/M guidelines state that each test that did not overlap results should be counted as one. Should we instead be counting based on the patient’s hospital chart?

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