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  • Ordered Tests and E/M Medical Decision-Making


    If a provider orders an OCT to be performed before the patient’s next office visit could this be counted as ordering a unique test in the data category for medical decision-making even if the provider can bill for it when the patient comes in for the test?

    No, the American Medical Association clarified the requirement: 

    Question: Do we receive credit for each unique test we either order or provide the interpretation/report, past or present?

    AMA answer: Any test with a CPT code current or past for which you receive/received separate payment does not count in the data category. 

    16 Questions and Answers About New E/M Definitions and Guidelines - American Academy of Ophthalmology (aao.org)