Last Modified: 9/8/2022
Location: FL, PR, USVI
Business: Part A, Part B
Q. When reviewing the amount and/or complexity of data to be reviewed and analyzed section, how are each unique source* and each unique test* in Category 1 counted?
A. The AMA – CPT E/M Office Revisions – Level of medical decision making table
indicates *Each unique test, order, or document contributes to the combination of two or combination of three in Category 1. For example, if a physician orders a complete blood count, basic metabolic panel and lipid panel, this counts as three unique tests. This would satisfy Category 1 of a moderate level of amount and/or complexity of data to be reviewed and analyzed.
(Must meet the requirements of at least 1 out of 3 categories)
Category 1: Tests, documents, or independent historian(s)
• Any combination of 3 from the following:
• Review of prior external note(s) from each unique source*;
• Review of the result(s) of each unique test*;
• Ordering of each unique test*;
• Assessment requiring and independent historian(s)
Category 2: Independent interpretation of tests
• Independent interpretation of a test performed by another physician/other qualified health care professional (not separately reported);
Category 3: Discussion of management or test interpretation
• Discussion of management or test interpretation with external physician/other qualified health care professional\appropriate source (not separately reported)
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.