decisionhealth Newsletters, Answer Books - 2010 Issue 11 (November)
Answer_Book / Mammography_Diagnostic / Discussion of results may justify separate EM service
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Article Overview
This premium article addresses a common coding question in diagnostic mammography: whether time spent discussing test findings with a patient can support a separate evaluation and management service. It is aimed at coders, billing staff, and radiology practices that need general guidance on distinguishing reportable E/M encounters from routine communication of test results. The discussion focuses on the broad E/M framework, counseling and coordination-of-care considerations, and documentation expectations.
Why This Topic Matters
Understanding when a separate E/M service may be considered can affect radiology billing accuracy and documentation practices. The topic is especially relevant for practices that provide direct patient communication after diagnostic imaging.
Article Sections
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Discussion of results may justify separate E/M service
Introduces the billing question and explains the general relationship between result review and separate E/M reporting. It frames the discussion around mammography and patient communication in a radiology setting.
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Counseling and abnormal findings
Addresses how abnormal findings and counseling time fit into the broader E/M framework. It also notes the importance of documentation and care coordination in this context.
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Example
Provides a brief illustrative scenario showing how time-based E/M considerations may be applied in an office encounter. The example is used to clarify the article’s general guidance.
What You Will Learn
- How the article distinguishes routine test-result discussion from separately reportable E/M services
- What broad E/M elements are relevant to patient encounters
- How counseling and coordination-of-care time are discussed in relation to abnormal findings
- Why documentation is emphasized when considering a separate service
- What type of scenario the article uses to illustrate the topic
Who Should Read This
- Radiologists
- Medical coders
- Billing staff
- Radiology practice managers
- Compliance personnel
Codes Discussed
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