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dgerry

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If the xray is performed in our office and the doctor views it and dictates a report is that 2 points for Independent visualization of image? Or just 1 point for x-ray ordered and/or reviewed. I hope you say 2 points! Thanks!
 
Well, we've had this very discussion in our office. There are some auditors (and consultants) who say that if you bill the global charge for the X-ray and the read that was done in your office, you can't also get data credit for your MDM at the same time. The rationale is that since you have a financial gain from performing xrays in your office, you can't also take advantage of that by ramping up your data points in your E&M. However, some of my auditors believe that you can at least get the single point for ordering/reviewing the xray, because you have to have the information to determine a treatment plan. Sorry I don't have a definitive answer..this might be one of those gray areas.

Anyone else want to weigh in?
 
Unfortunately I don't have a definitive answer either. We have been having this exact debate in our practice as well. We have been unable to locate a hard & fast rule about this issue.

- Jodie Doninger
 
Pam Brooks said:
Well, we've had this very discussion in our office. There are some auditors (and consultants) who say that if you bill the global charge for the X-ray and the read that was done in your office, you can't also get data credit for your MDM at the same time. The rationale is that since you have a financial gain from performing xrays in your office, you can't also take advantage of that by ramping up your data points in your E&M. However, some of my auditors believe that you can at least get the single point for ordering/reviewing the xray, because you have to have the information to determine a treatment plan. Sorry I don't have a definitive answer..this might be one of those gray areas.

Anyone else want to weigh in?
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Pam,

This has been a topic of discussion, too. Your comment... "There are some auditors (and consultants) who say that if you bill the global charge for the X-ray and the read that was done in your office, you can't also get data credit for your MDM at the same time. The rationale is that since you have a financial gain from performing xrays in your office, you can't also take advantage of that by ramping up your data points in your E&M.".... This has been my take on it for some time. My former MAC carrier also frowned on crediting the reading when the global charge was captured. I haven't found anything concrete with my new carrier but as a rule of thumb, I follow the conservative side.
 
Documentation guidelines read "direct visualization and independent interpretation of an inage, tracing, or specimen previously or subsequently interpreted by another physician should be documented." The key portion is interpreted by another physician.
 
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