Forum - Questions & Answers

May 17th, 2019 - damills    3 

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?

Jun 4th, 2019 - ChrisW   256  1 

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)" .

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