Wiki In the ED, can I code 93010 AND count this as "Independent Interpretation" for DATA?

[koster.kris@yahoo.com]

This is just about calculating the Data component.

Patient comes to ED with cough/fever/chest pain. EKG performed by a nurse and interpreted by ED physician, billed as 93010. Chest XR, CMP, CBC performed. Patient is diagnosed with Acute Bronchitis (viral), hemoptosis.

For calculating the Amount/Complexity of DATA, is it:

1) EKG, CXR, CMP, CBC (3+ Tests Ordered/Reviewed Satisfies Category 1) = Moderate Level

2) EKG, CXR, CMP, CBC (3+ Tests Ordered/Reviewed Satisfies Category 1) + Independent Interpretation of EKG (Category 2) = Extensive/High Level

For the last year, I have been under the assumption that if a physician bills for a service (like EKG interpretation), then it cannot ALSO count as an independent interpretation towards the MDM.

I keep reading the guidelines, but maybe I'm misinterpreting them:

Category 2: Independent interpretation of tests
■Independent interpretation of a test performed by another physician/other qualified health care professional (not separately reported);

Please help, thank you!!!

 

[Pam Warren]

You're correct. If the provider bills for the interpretation, they cannot also use that interpretation in MDM data. Also, when billing for an EKG interpretation, a report must be written; in most hospitals, a cardiologist is assigned to provide those reads, so the ED physician would not usually do that.

 

[koster.kris@yahoo.com]

You're correct. If the provider bills for the interpretation, they cannot also use that interpretation in MDM data. Also, when billing for an EKG interpretation, a report must be written; in most hospitals, a cardiologist is assigned to provide those reads, so the ED physician would not usually do that.

Thank you so much for replying. This is what I thought, but the Practicode coaches have told me differently.