Wiki CPT 87210 - Does it count towards Data MDM if the same provider bills for and interprets it?

[droque]

Our office bills for in-house Wet Prep Mount testing CPT code 87210. Does it not count toward Data MDM if the same provider bills for it? I am receiving different answers from several coders over this question since the code description specifically includes "with 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. Is it considered a results-only POC test? Can anyone provide great references/articles to support your answer to this? I thank everyone in advance for your help.

 

[beulastella]

https://www.ama-assn.org/system/files/2023-e-m-descriptors-guidelines.pdf page no 5

 

[amyjph]

If the provider is separately billing a line item for 87210, the provider is getting credit for the interpretation within the billing of the separate CPT 87210. They would be "double dipping" to also take credit for it within the E/M.

 

[droque]

I appreciate both your answers. With this I assume the Wet Mounts Code 87210 is not considered a Results-Only (POCT) Test correct?

 

[amyjph]

I appreciate both your answers. With this I assume the Wet Mounts Code 87210 is not considered a Results-Only (POCT) Test correct?

I would say no (my opinion). Even though it is CLIA waived and you state it is being done in house, it still, by definition requires interpretation. This is not the same thing as a simple, automated, result only POC test like a strep, Covid, glucose, etc.

 

[droque]

I would say no (my opinion). Even though it is CLIA waived and you state it is being done in house, it still, by definition requires interpretation. This is not the same thing as a simple, automated, result only POC test like a strep, Covid, glucose, etc.

Thank you!!! That is my current thought as well.