Correction: You can’t count ordering tests toward MDM If you perform and bill for them

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This correction article explains updates to two orthopedic evaluation and management scenarios from a prior issue of OCPS. It focuses on how medical decision-making elements are scored under current CPT/AMA guidance, especially data review, independent interpretation, and overall level of service. The piece is relevant to coders, auditors, and physicians who document office and emergency department-related orthopedic visits.

Why This Topic Matters

It clarifies how MDM elements are assessed in common orthopedic scenarios, helping readers understand the impact of test interpretation, problem severity, and surgical planning on E/M level selection.

Article Sections

  1. Scenario #1

    A revised orthopedic office visit scenario involving a new patient with knee symptoms and conservative treatment planning. The section discusses updated MDM element scoring and the resulting visit level.

  2. Scenario #2

    A revised established-patient scenario involving fracture evaluation after emergency department imaging and follow-up orthopedic management. The section discusses updated MDM element scoring and the resulting visit level.

  3. Q&A

    Reader questions and editorial responses about how the revised MDM elements were scored in the two scenarios. The section also notes that corrections were applied to the original online examples.

What You Will Learn

  • How a correction notice can affect evaluation and management scenario scoring
  • How MDM elements are discussed in orthopedic office and follow-up care examples
  • How independent interpretation and related data review issues are addressed in current guidance
  • How problem complexity and risk are considered in revised visit scenarios

Who Should Read This

  • Medical coders
  • Coding auditors
  • Physicians
  • Orthopedic practice staff
  • Revenue cycle professionals

Codes Discussed


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