Wiki Another MDM question

[MnTwins29]

This is coming up a lot now with the cold and flu season here - if the MD orders a rapid strep test (87880) and also records the results, does she get one MDM point for ordering a lab test AND two points for the visualization/results or just the one point for ordering? I can't find anything definitive one way or the other with this one.

Thanks.

 

[Biller385]

You would only receive one point value for the lab. Order and/or review medically reasonable and necessary clinical laboratory procedures (1-3 procedures).


Cathy

 

[MnTwins29]

Thanks

You would only receive one point value for the lab. Order and/or review medically reasonable and necessary clinical laboratory procedures (1-3 procedures).


Cathy

That confirms what I believe, but of course the docs I audit want "proof."

 

[kbartrom]

My understanding - the provider obtains credit for direct visualization only if the specimen, image, etc has been previously or will be subsequently interpreted by another physician. The 1995 DG states "On occasion the physician who ordered a test may personally review the image, tracing or specimen to supplement information from the physician who prepared the test report or interpretation; this is another indication of the complexity of data being reviewed." CMS's EM Services Guide states "The direct visualization and independent interpretation of an image, tracing, or specimen previously or subsequently interpreted by another physician should be documented."