2021 E/M Data Scoring

Prepare yourself, your staff and your providers for the 2021 E/M changes.

Moderators: NAMAS Moderator, Shannon DeConda

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lori
Posts: 47
Joined: Fri Aug 03, 2012 10:22 am

Wed Jul 07, 2021 4:55 pm

Hi. At an office visit, the cardiologist orders an echocardiogram which isn't performed on that day. It's unknown when or where the patient will eventually have the echo, who will bill for the professional component, and whether the patient will actually even follow through with having the echo at all.

My question is, can the cardiologist get Data credit toward the E/M for ordering the echo, since the echo hasn't been performed yet and since the professional component hasn't been billed separately as of the date of the E/M? Keep in mind that there's a possibility that this provider could end up billing the professional component for the echo if/when it's performed, which could be a month or two after the E/M occurred.

This is a common scenario but the language in the AMA guidance seems unclear on how to handle this. Thank you for your input!
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