Can a physician be paid for reviewing old records and x-rays
March 13th, 2009 - Codapedia Editor
A patient presents to the office with 100 pages of old records and a dozen x-ray copies to review prior to consultation. How can a physician be paid for that?
There is no separate reimbursement for record review. With the development of RBRVS, the pre and post work of services is included in the payment for the services themselves. There are codes (such as the non-face-to-face prolonged services codes) but these are typically not paid by insurers, and are considered bundled by Medicare.
It typically doesn't work to include this in time, because it doesn't happen face-to-face with the patient, and reviewing old records does not meet the definition of counseling.
It is true that reviewing and summarizing old records, and personally reviewing images and tracings can increase the medical complexity of the visit, and may result in an increased level of medical decision making. That can help in determining the level of service, but it is not automatic that this record review will result in either a higher MDM or level of service. It is certainly not a trump card.
The long and the short of it: a physician does not receive separate payment for record review, whether it is insignificant or extensive.
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