Forum - Questions & Answers
MDM in Table B
When a provider is ordering/reviewing an XR and independently visualizing and interpreting the same XR does the provider get 2 points or 3 points on table B (they are not separately billing for the XRay)?
In other words, do you get 1 point for ordering &/or reviewing, and then an additional 2 points for independent review of image, tracing, or specimen?
E.G. He has reviewed the x-ray report from the radiologist. = 1 point
He then takes the tracing and performs an independent visualization of his own, and documents his
findings. = addtl 2 points?
re: MDM in Table B
This information was taken from an E/M auditing sheet from Novitas, below is a table of points used to help assign MDM for the Amount and/or Complexity of Data Reviewed.
1- Review and/or order of clinical lab tests
1- Review and/or order of tests in the radiology section of CPT
1- Review and/or order of tests in the medicine section of CPT Discussion of test results with performing physician
1- Decision to obtain old records and/or obtain history from someone other than patient
2- Review and summarization of old records and/or obtaining history from someone other than patient and/or discussion of case with another health care provider
2- Independent visualization of image, tracing or specimen itself (not simply review of report)
TOTAL Points =
Here is the link to access the complete audit sheet, "Specialty Score Sheet: E&M (1995)" . https://www.novitas-solutions.com/webcenter/content/conn/UCM_Repository/uuid/dDocName:00004966