Wiki Ent and audiology and medical decision making

[DIVINE50]

I have a physician who sees a patient, sends them to the onsite audiologist and then the patient comes back to see the physician again (all on the same visit, has never left the office). The physician reads the printed audiology report from the machine showing hearing levels,etc. (not the audiologist findings report that the audiologist dictates)...

When the physician is doing her medical decision making she is giving herself 2 points for independent visualizaion of image, trace or specimen itself(not simply reivew of report) but my question is:

Since the physician is referring to the audiologist to have the hearing test done and then reads the audiology report wouldn't that be 1 point under review and/or order test in medicince section (90000 code series) and only be worth 1 point?

Can anyone tell me how this should be done and also can anyone find a description of what exactly this means: Independent visualizaion of image, trace or specimen itself(not simply reivew of report).


Thanks so much for all your help

 

[smoore123]

Audiology

Is this being billed under the provider's NPI number that is trying to get the credit for the independent visualization? If so then they can only receive 1 point in data. Below is a FAQ from Novitas.

Evaluation & Management (E/M) Contractor Decisions: Independent Visualization

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If a provider is billing for the professional component of a test in the radiology and/or medicine section of the Current Procedural Terminology (CPT) Manual and an Evaluation & Management (E/M) procedure code on the same date of service, should that physician receive credit under the Independent Visualization of an image, specimen or tracing component in the Amount and /or Complexity of Data Reviewed Section of the Medical Decision Making key component of an E/M?

If the provider is billing separately for the interpretation of a test in the radiology and/or medicine section of the CPT, then that same physician should not take credit for the independent visualization of that test in the Amount and /or Complexity of Data Reviewed Section of the Medical Decision Making key component of an E/M.

The 1995 E/M Documentation Guidelines address this issue on page 13 and state that, "The direct visualization and independent interpretation of an image, tracing or specimen previously or subsequently interpreted by another physician should be documented."

If the provider is not billing separately for the interpretation of the test or the test was performed by another provider and that physician is independently visualizing the test, then the provider may take credit for the independent visualization of that test in the Amount and /or Complexity of Data Reviewed Section of the Medical Decision Making key component of an E/M


http://www.novitas-solutions.com/we...ntentId=00004948&_adf.ctrl-state=7n1h3lf6e_54

 

[DIVINE50]

Thank you so much for sending me that link! I have been trying to find anything about this and have had such a hard time.