Wiki Can we count MRI discussion as ordering a test?

[wynonna]

Hello:
An MRI might be more helpful but patient is not a great candidate due to his heart valve and joint replacements. His pacemaker has been changed out to something that is thought to be safe for MRI.
Patient suspects his symptoms are related to a medication that he reacted to in the past. He has an appt with primary care MD to review all the recent workup.
Would this qualify as as ordering a test since a discussion took place even though MD and patient decided against MRI?
thank you

 

[csperoni]

Yes, per the AMA 2021 Outpatient E/M guide:
"Ordering a test may include those considered, but not selected after shared decision making. For example, a patient may request diagnostic imaging that is not necessary for their condition and discussion of the lack of benefit may be required. Alternatively, a test may normally be performed, but due to the risk for a specific patient it is not ordered. These considerations must be documented. "