NAMAS Webinar Q&A: 2021 CPT Update 01/05/2021

Post here your questions regarding auditing ,coding, documentation, and compliance. Also, join in on the conversation- help your fellow auditors and compliance professionals in the industry.

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Thu Jan 14, 2021 12:06 pm

Below are the questions received during our recent webinar, 2021 CPT Update, originally presented on January 5, 2021. There questions have been answered by the webinar presenter, Brenda Edwards, CPC, CDEO, CPB, CPMA, CPC-I, CEMC, CRC, CPMA, CMRS, CMCS.

Question 1:
If you’re billing the CPT, you cannot get credit for ordering? And, if you’re billing the CPT, you cannot get credit for reviewing?
Answer 1:
Correct, if the provider is billing a separately identifiable service with a CPT code, you do not count it in the EM determination because the provider is already being compensated for it.

Question 2:
If you’re not billing the CPT, you can get credit for ordering? And if you’re not billing the CPT, you can get credit for reviewing, but only if you did not order it (whether you reviewed same visit or next visit- you can never get credit for reviewing a test you ordered)?
Answer 2:
Correct otherwise it would be counted as double dipping

Question 3:
If you’re not billing CPT, you can get credit for both ordering & reviewing same visit if the order & review are for different tests & the test reviewed was not ordered by you?
Answer 3:
You are correct!
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