Wiki question about determining the MDM level in a case

[The Angel Of the South]

For my practicode. When determining the "amount and/or complexity of data to be reviewed and analyzed" for the MDM level, what does or doesn't qualify as data to be reviewed and analyzed? I thought any kind of tests that get run and then studied would count.

In a case where I coded 99215 when the rationale says 99214, it says "Amount and/or complexity of data to be reviewed and analyzed: None." I thought "What are you talking about?", because the procedures were a resting EKG and a resting echo that obviously had to be interpreted. I thought the EKG and echo would count toward the level of MDM--they're data. They don't count, since the rationale says there was no data to be reviewed/analyzed? Then what kind of data am I supposed to be looking for?

(Tried to post a screenshot of it, but I'm getting a server error.)

 

[Orthocoderpgu]

Per the new 2021 E/M guidelines, if a test is performed during the E/M, and it' a test that the doctor is going to bill, then it would not be counted towards the E/M since the provider is already getting paid for whatever test they ordered and reviewed.

 

[csperoni]

Yes, any test where the clinician who ordered is performing the professional component of the test is not counted.
Rationale is that you are getting paid for that work by billing for the test itself.
Per the AMA 2021 Outpatient E/M guidelines:
Analyzed: The process of using the data as part of the MDM. The data element itself may not be subject to analysis (eg, glucose), but it is instead included in the thought processes for diagnosis, evaluation, or treatment. Tests ordered are presumed to be analyzed when the results are reported. Therefore, when they are ordered during an encounter, they are counted in that encounter. Tests that are ordered outside of an encounter may be counted in the encounter in which they are analyzed. In the case of a recurring order, each new result may be counted in the encounter in which it is analyzed. For example, an encounter that includes an order for monthly prothrombin times would count for one prothrombin time ordered and reviewed. Additional future results, if analyzed in a subsequent encounter, may be counted as a single test in that subsequent encounter. Any service for which the professional component is separately reported by the physician or other qualified health care professional reporting the E/M services is not counted as a data element ordered, reviewed, analyzed, or independently interpreted for the purposes of determining the level of MDM.