decisionhealth Newsletters, Coder Pink Sheets - 2023 Issue 5 (May)
After AMA correction, review the rules for counting a test interpretation toward MDM
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Article Overview
This article reviews an AMA technical correction related to E/M medical decision-making and the treatment of test ordering, review, and interpretation. It is aimed at coding and billing professionals who support accurate E/M reporting and need a practical understanding of how the clarification affects data review counting without changing the underlying guidelines. The discussion focuses on general rules, timing considerations, and when a practice may or may not count test activity toward a visit.
Why This Topic Matters
The clarification affects how practices count test-related work in E/M medical decision-making, which can influence code selection and compliance. Understanding the scope of the update helps teams avoid misapplying the rule when the practice also performs the test or when ordering and interpretation occur on different dates.
What You Will Learn
- How an AMA correction relates to E/M medical decision-making
- How test ordering and interpretation are generally treated in data review
- How timing of test orders and interpretation can affect visit attribution
- Why practices should distinguish between separately reported tests and E/M data review counting
Who Should Read This
- Coders
- Billers
- Practice managers
- Physicians
- Other qualified health care professionals
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