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MDM Data Points????

  1. Default MDM Data Points????
    Medical Coding Books
    If the physician orders a basic metabolic panel; 1 test which produces 8 lab results; does each result reviewed count as a data point in the physician's level of MDM; also does he get one point for ordering the test and another for reviewing it? Same thing with radiology data; if the provider orders and reviews a chest x-ray and a CT of the head how many points does that produce?

    Thanks for your help!!

  2. #2
    Location
    Greeley, Colorado
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    2,045
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    You get 1 point for reviewing/ordering lab (regardless of how many tests); 1 point for reviwing/ordering radiology (regardless of how many tests). If there is an indepenent visualization of the image, tracing or specimen ("not simply reviewing the report") you can add 2 more points. Hope that helps.

  3. Default
    If they physician is stating ECG, ECHO, Holter results in note and also bills for these tests in addition to the E/M visit--are any points given? (1 pt for tests in medicine section, 2 pts for independent visualization of image, etc?)

    Thanks for your help

  4. #4
    Location
    Overland Park, KS
    Posts
    1,166
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    Ok now I have a question about this.......If the physician orders an x-ray he gets 1 point regardless of the number that he/she orders, but if he reviews the x-ray, he/she gets two points. What constitutes independent visulation of the image, tracing, or specimen? If the physician orders the x-ray and then looks at it after the radiologist does, then does he/she get two additional points or is that considered double dipping? Can anyone point me to the specific guidance that might help to clarify this? Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  5. #5
    Location
    Duluth, Minnesota
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    1,133
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    Dawson,
    The provider must document independent visualization of an image, tracing or specimen in order to count 2 points.
    If the provider separately bills for the independent visualization (e.g. prepares a written report for an X-ray), do not count this for purposes of Data Reviewed as the provider is receiving separate reimbursement for this service.
    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

  6. #6
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    So if the provider orders the x-ray and documents that he/she reviewed it, they get points for both?
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  7. #7
    Location
    Duluth, Minnesota
    Posts
    1,133
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    Dawson,
    if the provider order and review of laboratory, x-ray or diagnostic study results they get -1 point for X-ray, 1 point for lab (not for each test)

    if the do an Independent visualization of image, tracing or report -Performing a diagnostic interpretive service or discussing the diagnostic test result with the interpreting physician..2 points TOTAL (not each)
    {so total of 3 points}.
    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

  8. #8
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    Thanks.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

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