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Orthopedic Coding Alert

Reader Question:

Count X-Ray Read Toward E/M Level

Published on Wed Mar 17, 2004

Question: If our orthopedist orders an x-ray and provides personal, independent visualization of the image, how many points should I add to the E/M level?

Connecticut Subscriber Answer: If you are auditing this service according to Medicare's 1997 E/M Documentation Guidelines, you can add points to an E/M level based on medical decision-making elements during the visit.

For example, suppose your orthopedist orders an x-ray (73070, Radiologic examination, elbow; two views). Because he ordered a radiological test from CPT's radiology section, he can add one point to the E/M service. If the physician reviews the report on the patient's next visit, he can receive one point for reviewing the radiological test. And, when the orthopedist personally views x-ray films, he can add two points to the E/M's medical decision-making.
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