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Amount and/or Complexity of Data

  1. Default Amount and/or Complexity of Data
    Medical Coding Books
    A provider asked me today if this scenario=2 or 3 points: patient comes in with respiratory problem and he orders a chest xray and come back(same day) and they will review the film together. He personally reviews(and documents) the CXR and discusses with the patient. Does he "get" 3 for ordering and visualizing the image?

  2. #2
    North Carolina

    Depending on who you may get different answers.

    I do not allow extra credit for direct visualization/indepedent interp of labs or radiology when we are billing for the global component. The payment for the interp is captured in the professional component of the lab or xray. Now...I DO allow direct visualization/independent interp when my neurosurgeons (for example) receive a CD and provide an independent interp of their "findings" since we are not billing for the MRI. Of course, they thoroughly document their "findings" through the independent/visualization process.

    I do have to add that I have attended a couple of E/M/Auditing seminars conducted by the AAPC and this was also the representatives view. Personally, I feel like it's "double dipping" when allowing credit for the independent vis. if you're already being compensated for the global component. With that being said, I have written my carrier for their view but remain firm on my opinion until proven otherwise by my carrier.
    Last edited by RebeccaWoodward*; 12-08-2009 at 04:59 PM. Reason: spelling
    Rebecca CPC, CPMA, CEMC

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