I was having a meeting with a Coding company that told me that a FLU test or COVID test does not count as an ordered test for complexity of data when leveling service. Can someone please help me understand this? I was under the impression that it did count. They said they got this information from Credit Intel? Then said AAPC. Thanks.
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Resolved What Constitutes as An Ordered Test for E/M?
- Thread starter NatashaP_63838
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Lori
Well-known member
Let's see what Alicia or Jennifer say.
Test: Tests are imaging, laboratory, psychometric, or physiologic data. A clinical laboratory panel (eg, basic metabolic panel [80047]) is a single test. The differentiation between single or multiple unique tests is defined in accordance with the CPT code set.
The AMA is consistent in this instruction. If you order a diagnostic test, say a CBC at a patient visit, reviewing the results that day, or, a day later, or at the subsequent visit, it is part of the order. When the patient returns to the office two weeks later, you do not get credit for reviewing the CBC results that you ordered. Count the data for the test once, at the encounter when it was ordered.
(f) Screening for COVID-19
During the COVID-19 pandemic, a screening code is
generally not appropriate. For encounters for
COVID-19 testing, including preoperative testing,
code as exposure to COVID-19 (guideline
I.C.1.g.1.e).
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www.ama-assn.org
https://www.ama-assn.org/system/files/2019-06/cpt-office-prolonged-svs-code-changes.pdf
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Test: Tests are imaging, laboratory, psychometric, or physiologic data. A clinical laboratory panel (eg, basic metabolic panel [80047]) is a single test. The differentiation between single or multiple unique tests is defined in accordance with the CPT code set.
- A panel of lab tests is considered a single, unique test.
- Lab tests with their own CPT® code are considered unique tests. A mono-spot and a quick strep test each have their own CPT® codes; if ordered, those would be two unique tests.
- There is separate counting for ordering and for reviewing the unique test.
- Tests included lab tests, in the 80000 series of codes.
- Tests include diagnostic tests, in the 70000 series of codes
- Tests include the medical tests in the medicine chapter, in the 90000 series of codes.
The AMA is consistent in this instruction. If you order a diagnostic test, say a CBC at a patient visit, reviewing the results that day, or, a day later, or at the subsequent visit, it is part of the order. When the patient returns to the office two weeks later, you do not get credit for reviewing the CBC results that you ordered. Count the data for the test once, at the encounter when it was ordered.
(f) Screening for COVID-19
During the COVID-19 pandemic, a screening code is
generally not appropriate. For encounters for
COVID-19 testing, including preoperative testing,
code as exposure to COVID-19 (guideline
I.C.1.g.1.e).
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CPT®
Review the criteria for CPT® Category I, Category II and Category II codes, access applications and read frequently asked questions.
www.ama-assn.org
https://www.ama-assn.org/system/files/2019-06/cpt-office-prolonged-svs-code-changes.pdf
We also just released a CEU training Mini-Course for EM 2021 here for current CCO Club members only https://www.cco.community/resources/2021-e-m-mini-course.617/
Not a club member you can join here:
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