E/M ordering of each unique test - 2023

[coderD814]

If my provider orders an xray (done in office) on the day of the encounter, he is billing for both PC & TC as the practice owns the equipment, can this be counted at as ordering unique test for this encounter only?

 

[jkyles]

If my provider orders an xray (done in office) on the day of the encounter, he is billing for both PC & TC as the practice owns the equipment, can this be counted at as ordering unique test for this encounter only?

Hi there,
As the CPT guidelines state, you cannot count a test toward an E/M visit when the practice bills for the test. The only exception is a "results only" test that doesn't require additional interpretation (such as a rapid strep test). You can count those tests as an order or review.

This is under the Services Reported Separately section of the E/M guidelines in your CPT manual.

 

[coderD814]

Thank you!