Wiki E & M Data Points

medicalsec

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I am a little confused when calculating the data points for the E & M charges. If the doctor looks at the x-ray/CT reports etc. supplied by the radiologist, and he also personally visualizes the films will he get 3 points (Review of the Radiology Section and Independent Visualization of Image. Also, do you count points for each film that is reviewed.

Thanks,

Dee
 
Data point

You would get 1 point for review and/or order of studies in Radiology section. (whether you reviewed OR ordered 1 xray or 20 ... you get 1 point)

You would get 2 points for independent visualization of image, tracing or specimen (NOT just review of the report). Again, whether you looked at 1 image or 20 - just 2 points.

So if you did BOTH, order/review Xray AND independently visualized the Xray you would get a total of 3 points. I find that it's hard to get the physician to document that s/he actually viewed the films him/herself.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
Just a side note...

I attended an auditing conference over the weekend and thought I would share this tid bit.

If your provider ordered and independently visualized the xray AND is billing for the global component of the xray, CT, etc...you can only allow points for the ordering. The independent visualization points are already captured in the payment for the professional component of the xray, CT, etc.
 
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