Which type of tests are explicitly considered in MDM despite not being billed with separate CPT codes?

Which type of tests are explicitly considered in MDM despite not being billed with separate CPT codes?

• A. Point-of-care tests
• B. Imaging tests
• C. Hospital laboratory tests
• D. Medication reconciliation tests

Answer: (A)

In MDM the amount and type of data reviewed help determine the level of decision making, and tests that generate data are counted toward that data complexity. Point-of-care tests are performed right at the bedside or in the clinic and often don’t produce a separate CPT billing code. Yet their results are real data the clinician reviews and uses to shape the treatment plan, so they’re explicitly counted in MDM even though they aren’t billed separately. Examples include rapid glucose checks, rapid strep tests, or urine dipstick results obtained in the office. Imaging studies and hospital laboratory tests typically have CPT codes and are counted when their results are reviewed, but they aren’t the category defined by lack of separate billing. Medication reconciliation isn’t a test but a data item about the patient’s current medications, so it doesn’t fit as a test type.

In MDM the amount and type of data reviewed help determine the level of decision making, and tests that generate data are counted toward that data complexity. Point-of-care tests are performed right at the bedside or in the clinic and often don’t produce a separate CPT billing code. Yet their results are real data the clinician reviews and uses to shape the treatment plan, so they’re explicitly counted in MDM even though they aren’t billed separately. Examples include rapid glucose checks, rapid strep tests, or urine dipstick results obtained in the office. Imaging studies and hospital laboratory tests typically have CPT codes and are counted when their results are reviewed, but they aren’t the category defined by lack of separate billing. Medication reconciliation isn’t a test but a data item about the patient’s current medications, so it doesn’t fit as a test type.