Wiki Clarification on ordering and review of tests

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Lungaro

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Hello! My DR's are asking for some clarification on tests and how to count towards level of coding/billing.
If we do in house labs (streps, covids, rsv, flu), they can only count them as "one point". They can not count as two (ordered and reviewed)?
One example, we do a strep test in house and send the culture for back up.
Second example is we do a Covid and a Flu test in the office.
Any help would be appreciated. I have tried explaining, but they would like some outside clarification.
Thank you!
 
From the CPT manual:

Tests that do not require separate interpretation (eg, tests that are results only) and are analyzed as part of MDM do not count as an independent interpretation; however, they may be counted as ordered or reviewed for selecting a level of MDM.
Click to expand...

If your practice bills tests that require separate interpretation, they can't be counted toward MDM.
 
https://www.ama-assn.org/system/files/2019-06/cpt-office-prolonged-svs-code-changes.pdf
also has a lot of helpful information.
Summary:
Reviewing a test you ordered is not counted separately. It is included in the order
If you are ordering a test and not performing it, you count 1 point for each test.
If you are ordering a test and performing it, you only count 1 point for each test that does NOT require separate interpretation.
 
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