Wiki Amount/complexity of data

[SHoltzenCPC]

This may be a dumb question, but....if my provider documents he reviewed an MRI report and also interprets the actual MRI cd, does he get 2 points for amount/complexity of data? Would it be 1 in category I for review of the results of a unique test and also 1 in category 2 for independent interpretation of a test performed by another source? The patient had an outside MRI done, my provider reviewed the report and also interpreted the actual views. Is that a point for each category or is that double dipping? Thanks

 

[suzannel]

I asked an internal AAPC member, and she said:

So not a dumb question. If the provider has interpreted a test from an external physician or one of a different specialty, he can count that as 1 point under Independent Interpretation of tests. This would fall under Category 2 under the Moderate and high data levels in MDM. This would apply if he has interpreted the results by looking at the scan or test itself and not just the report. If the provider only looked at the report and did no interpretation, you could count this under Category 1 and it would fall under review of test. You would not be able to count it twice because that would be double dipping. It would make the most sense to count it under Category 2 under moderate if they did in fact interpret the test because it would yield the higher level immediately since you’d only need to meet one of the 3 elements of data for Moderate level.

Hope this helps!

 

[SHoltzenCPC]

Yes that helps so much. Thank you for your time!