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Last Modified: 9/8/2022 Location: FL, PR, USVI Business: Part A, Part B

Amount and/or complexity of data – Office/Outpatient, 2021

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 external pdf file 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.
Moderate
(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)
or
Category 2: Independent interpretation of tests
Independent interpretation of a test performed by another physician/other qualified health care professional (not separately reported);
or
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)
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