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Have question for E and M expert

  1. #1
    Location
    Orange County
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    60
    Wink Have question for E and M expert
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    If part of the MDM in selecting a level contains additional "points" for ordering or reviewing any tests from the "medicine" section (i.e. code 93000), can a provider also bill for the 93000 (EKG) in addition to the E and M? It seems like double dipping to me, but would appreciate assistance with this question. Thanks everyone!

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default No double dipping
    If you are billing out the interpretation/report of a diagnostic test then you cannot also count that "independent review" as additional data points ... but you CAN still get 1 point for ordering the test.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Location
    Orange County
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    60
    Default
    so just that I am clear..... If my doc wants to bill out his EKG ...he cannot add the additional MDM points. He insists on billing out his EKGs. So he gets an MDM point for the "order", but not interpretation of the report. correct?
    Thanks for your help!!

  4. #4
    Location
    North Carolina
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    3,126
    Default
    Quote Originally Posted by myeo View Post
    so just that I am clear..... If my doc wants to bill out his EKG ...he cannot add the additional MDM points. He insists on billing out his EKGs. So he gets an MDM point for the "order", but not interpretation of the report. correct?
    Thanks for your help!!

    If you're provider bills for the global component of the EKG, he does not receive points for the independent review of image. This is already captured in the payment for the global component of the EKG; however, the provider does receive one point for the ordering of the EKG. This allows credit for the cognitive process that led him to decide to order the test.

  5. #5
    Location
    Orange County
    Posts
    60
    Default
    Thank you!!

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