CPT Knowledgebase - Nov 3, 2021

If an otherwise separately reportable test is ordered by the physician or other QHP and used in the MDM at the encounter (99202-99215), but is not billed, may the test be counted when selecting the MDM level? For example, in ophthalmology, when optical coherence tomography (92134) and fundus photography (92250) are ordered, performed, and documented (review and report), and used as part of the MDM level selection for the encounter (99202-99215), code 92250 cannot be reported with code 92134; therefore, code 92250 is not reported.

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