Combination POCTs and credit in the data element of MDM

[2021woW]

Hello everyone,

In desperate need of help. I’m getting conflicting advice regarding how to count combination point of care tests. Specifically if there is a point of care test, one swab that tests Flu A/B and COVID. Does that count as 1 ordered test because there is only 1 CPT code. Does it count as 2 ordered tests (1 for the Flu A/B result and 1 for the COVID result). or does it count as 3 ordered tests (1 for Flu A, 1 for Flu B and 1 for COVID). Please provide a reference so I can back up my answer, please. I have looked and am not finding a lot about this other than multiple reference saying it would only count as 1 due to 1 CPT code for the test.

Respectfully yours,
Danté

 

[csperoni]

It seems like you are stating you found "multiple references saying it would only count as 1 due to 1 CPT code for the test." Those references are correct. It is stated clearly in the AMA E&M guidelines.
Test: Tests are imaging, laboratory, psychometric, or physiologic data. A clinical laboratory
panel (eg, basic metabolic panel [80047]) is a single test. The differentiation between single or
multiple tests is defined in accordance with the CPT code set. For the purpose of data reviewed
and analyzed, pulse oximetry is not a test.
Unique: A unique test is defined by the CPT code set. When multiple results of the same unique
test (eg, serial blood glucose values) are compared during an E/M service, count it as one unique
test. Tests that have overlapping elements are not unique, even if they are identified with distinct
CPT codes. For example, a CBC with differential would incorporate the set of hemoglobin, CBC
without differential, and platelet count. A unique source is defined as a physician or other
qualified health care professional in a distinct group or different specialty or subspecialty, or a
unique entity. Review of all materials from any unique source counts as one element toward
MDM.