How to count data reviewed correctly


Merrill, WI
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If,for example, a dr reviews an x ray, a CT, orders another xray, can I only give 1 point since they all fall under the review/order radiology section, or can I give 1 point for each since they are all seperate?
Personally, I would only allow one credit for the order and review of the radiology exam; however, I do allow credit for independently reviewing a CT or MRI scan. Our neurosurgeons review MRI's (on CD's) to determine if surgery is needed. This certainly can be time consuming.

1. Add up the problem points
2. Add up the data points <-------(click here) If you click on the highlighted blue areas, it provides a scenerio for when it is allowed to credit the MDM. If you want to "calculate" your MDM, use the's kinda cool.
3. Stratify the risk
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review and/or order

You get ONE point for "review and/or order of tests in the radiology section."

You get TWO points for "independent visualization of image, tracing or specimen itself (not simply review of report)."

So if the Doctor is actually looking at the Xray and CT images himself (not just reviewing the radiologist's report), then ordering another Xray, I'd award a total of 3 points (2 for reviewing the images himself, one for ordering the Xray).

F Tessa Bartels, CPC, CPC-E/M