tci E/M Coding Alert - 2021 Issue Q1

Reader Questions: Test Your Knowledge of MDM Data Guidelines

Question: If a provider is billing based on medical decision making (MDM), not on time, can he count test results he has received on a different date of service toward the amount or complexity of data to be reviewed and analyzed element of MDM? Missouri Subscriber Answer: CPT® guidelines state: “The amount and/or complexity of data to be reviewed and analyzed … includes medical records, tests, and/or other information that must be obtained, ordered, reviewed, and analyzed for the encounter.… It includes interpretation of tests that are not separately reported. Ordering a test is included in the...

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