Wiki 2021 MDM table

MelodyCPC

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In regard to the Complexity of Data -

My question is about the "*Each unique test, order, or document contributes to the combination of 2 or combination of 3 in Category 1"

What counts as a unique test or order?

For example:
At a patient encounter, physician places orders for TSH lab, Chlamydia lab, and FSH lab, UA lab - are these:
4 unique lab tests (TSH, FSH, UA, Chlamydia)
3 (urine, blood, swab) or
or just one because they are all labs?
 
Four- each test represented by one CPT code is counted separately. However, when a code represents multiple tests (e.g., lab tests described by a panel code), only one is counted. If you have a copy of the new guidelines, see the definition of test.

Best wishes,
Cindy
 
Does it mean that if two separate blood tests are ordered, each having their own CPT code, you will automatically meet the Category 1 combination of 2 for Low Data section?

Or, if you ordered Urinalysis and EKG, do you meet the Category 1 combination of 2 for Low Data section?

Thank you!
Maiu
 
Does it mean that if two separate blood tests are ordered, each having their own CPT code, you will automatically meet the Category 1 combination of 2 for Low Data section?

Or, if you ordered Urinalysis and EKG, do you meet the Category 1 combination of 2 for Low Data section?

Thank you!
Maiu
Yes. Ordering 2 distinct tests (each represented by a separate CPT and not a component of the other) meets the requirements for low amount/complexity of data. However, you cannot count any separately reportable test or study performed during the encounter. Cindy
 
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