Wiki E/M Data question: Two different providers. Clinic setting

[kknutson15]

Hi,
I have a question about E/M credit under the Data section involving review of unique tests. The AMA site states that '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.' I have a situation in a Rural Health Clinic setting:

Provider A ordered tests for a patient in one encounter. A few days later a different provider (Provider B) is reviewing the results and explaining them to the patient in a separate encounter. Both providers work in the same clinic and are same specialty (Family Medicine) providers. When this happens, does Provider B get credit for reviewing the tests since they are not the ordering provider?

 

[csperoni]

No. The credit for ordering the test includes the review. The fact that it happened to be Provider B working on the second encounter does not mean your practice was not already paid for the work.
From the AMA guidelines: "Ordering a test is included in the category of test result(s) and the review of the test result is part of the encounter and not a subsequent encounter."

 

[kknutson15]

Thank you!