Wiki photos of lesion count in any way?

[wynonna]

How do we count photographs that an MD is viewing and evaluating?
(They are Not CT/MRI imaging)
thx

 

[jkyles]

Hi there, who took the pictures?

 

[wynonna]

Unknown, but what if patient took the pictures himself?
thx

 

[jkyles]

Got it - If the patient took the picture (or the source of the photo isn't known) then you can't count it toward MDM because it hasn't come from an external source as defined in the CPT manual.

 

[thomas7331]

Unknown, but what if patient took the pictures himself?
thx

If that was the case I'd consider it part of the HPI or exam, not of the MDM.

But in odd situations like this, you kind of have to make a judgment call. There aren't E/M guidelines to tell you how to classify every unusual situation you're going to come across in a medical record.

 

[wynonna]

thank you!
I focused on the key word "IMAGING" from Tests in MDM guidelines and whether that applies to pictures.
excerpt: Upper endoscopy report and photographs are reviewed; appears to be a small lymphoid deposit of the right lateral pharyngeal wall, not oral cavity

 

[csperoni]

If your physician is viewing endoscopy photos from another physician outside your practice and interpreting the findings, you could likely count this under data as Independent Interpretation of Tests. From the AMA 2021 Outpatient E/M guidelines:
Independent interpretation: The interpretation of a test for which there is a CPT code and an interpretation or report is customary. This does not apply when the physician or other qualified health care professional is reporting the service or has previously reported the service for the patient. A form of interpretation should be documented but need not conform to the usual standards of a complete report for the test.

I think it rather unlikely the patient took their own endoscopy photos.

 

[wynonna]

Yes, I just found out from MD that they were photos taken by MD, (perhaps during a colonoscopy or esophagoscopy)
So he scores for independent review.
thank you all for your help!

 

[KillianL]

It is my understanding that if the physician performs the EGD, he does not get to count the EGD or photos taken from the EGD as data points. He has already been paid for the EGD. It would not be considered an independent review.

 

[wynonna]

Yes you're right. But these photos were taken by a different, external, MD. Most likely a gastroenterologist and we are ENT.
So I see independent review from outside source.
thank you