BC Advantage - 2021 Issue 4

Q/A: For E/M, How do I Count Tests Ordered in One Department and Performed in Another?

Question: I am in an ENT office as part of a large clinic with separate practices including audiology, CT, and allergy, all billing under the same TAX ID. Sometimes tests are ordered which are done in other departments that my office does not bill for, would those be considered an outside source?Answer: This is a great question and one that has been asked by many coders and auditors. To answer it, we begin by looking at the following CPT definition for "External physician or other qualified healthcare professional" as noted in the AMA's Errata and Technical Corrections -...

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