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We have encountered a recurring grey area regarding Services Reported Separately under MDM Data Reviewed and Analyzed. Specifically, I am seeking clarity on whether our in-house labs can be counted towards MDM. There seems to be some confusion over which labs are classified as providing interpretation versus those categorized as Results-Only and their contribution to MDM.
One particular area of concern is the classification of Wet Mount Preps (CPT 87210). My research has led me to conflicting information about whether these should be considered results-only tests or tests requiring interpretation. It appears that Wet Preps, as a type of Provider-Performed Microscopy (PPM), involve direct examination and interpretation of findings such as yeast, trichomonads, and clue cells by the provider, which assists in diagnosis. The code specifically includes “with interpretation,” indicating that this aspect is integral to the service, thereby categorizing Wet Preps as tests that require independent interpretation by a qualified professional.
I understand that the AMA guidelines state the ordering and performance or interpretation of diagnostic tests during a patient encounter are not included in the E/M service levels when the interpretation is reported separately. For coding purposes, if the same provider performs and interprets the wet mount, it typically cannot be counted under the "ordered or reviewed" data category. Is this correct?
I would appreciate everyone's expertise and thoughts on this matter.
One particular area of concern is the classification of Wet Mount Preps (CPT 87210). My research has led me to conflicting information about whether these should be considered results-only tests or tests requiring interpretation. It appears that Wet Preps, as a type of Provider-Performed Microscopy (PPM), involve direct examination and interpretation of findings such as yeast, trichomonads, and clue cells by the provider, which assists in diagnosis. The code specifically includes “with interpretation,” indicating that this aspect is integral to the service, thereby categorizing Wet Preps as tests that require independent interpretation by a qualified professional.
I understand that the AMA guidelines state the ordering and performance or interpretation of diagnostic tests during a patient encounter are not included in the E/M service levels when the interpretation is reported separately. For coding purposes, if the same provider performs and interprets the wet mount, it typically cannot be counted under the "ordered or reviewed" data category. Is this correct?
I would appreciate everyone's expertise and thoughts on this matter.