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Another MDM question

  1. #1
    Location
    Ellenville, New York
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    1,176
    Default Another MDM question
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    This is coming up a lot now with the cold and flu season here - if the MD orders a rapid strep test (87880) and also records the results, does she get one MDM point for ordering a lab test AND two points for the visualization/results or just the one point for ordering? I can't find anything definitive one way or the other with this one.

    Thanks.

    Lance Smith, MPA, COC, CPMA, CEMC, RHIT, CCS-P, CHC, CHPC

    Director, Health Information Management
    HealthAlliance of the Hudson Valley
    Kingston, NY


    2016 Secretary
    Ellenville, NY Local Chapter

  2. #2
    Location
    Ft. Worth, Texas
    Posts
    108
    Default
    You would only receive one point value for the lab. Order and/or review medically reasonable and necessary clinical laboratory procedures (1-3 procedures).


    Cathy

  3. #3
    Location
    Ellenville, New York
    Posts
    1,176
    Default Thanks
    Quote Originally Posted by Biller385 View Post
    You would only receive one point value for the lab. Order and/or review medically reasonable and necessary clinical laboratory procedures (1-3 procedures).


    Cathy
    That confirms what I believe, but of course the docs I audit want "proof."

    Lance Smith, MPA, COC, CPMA, CEMC, RHIT, CCS-P, CHC, CHPC

    Director, Health Information Management
    HealthAlliance of the Hudson Valley
    Kingston, NY


    2016 Secretary
    Ellenville, NY Local Chapter

  4. #4
    Default
    My understanding - the provider obtains credit for direct visualization only if the specimen, image, etc has been previously or will be subsequently interpreted by another physician. The 1995 DG states "On occasion the physician who ordered a test may personally review the image, tracing or specimen to supplement information from the physician who prepared the test report or interpretation; this is another indication of the complexity of data being reviewed." CMS's EM Services Guide states "The direct visualization and independent interpretation of an image, tracing, or specimen previously or subsequently interpreted by another physician should be documented."

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