Wiki Question regarding viewing and interpreting outside x-ray

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ortho1991

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Please help, One of our new Ortho physicians is seeing a pt that was referred to him for the first time, pt brought outside x-rays physicians questions if or how does he get credit for view and giving his own interpretation of them. The old guidelines state under Data to be reviewed, that 2 points are given for Independent review of image, tracing or specimen. Would this fall into that category? Thank you.
 
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In this is an office/outpatient 2021 or later visit, credit would be given under the amount and complexity of data to be reviewed or analyzed in MDM. you can't use the "old" guidelines. It is either credit for review of the results of each unique test, or independent interpretation of the test. Since this is an outside X-Ray and your provider didn't separately report the CPT for the XR you can count it toward the E/M MDM. it would be moderate for that element of MDM. (Independent interpretation of a test performed by another physician/other qualified health care professional (not separately reported)

The provider must be very clear in documenting that they actually independently interpreted the films and didn't simply review the report.
If a test/study is independently interpreted to manage the patient as part of the E/M service, but is not separately reported, it is part of medical decision-making.
 
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Hi there, if they did an independent interpretation as defined by the new guidelines that is scored as moderate data.
 
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