Medical Auditing Practice Exam

How is a chest X-ray that is billed by a provider reported for the E/M MDM element?

1. Separately - as an additional procedure

2. Included, with no separate billing

3. As a non-billable service

4. As an emergency service

The correct answer is: Included, with no separate billing

In the context of evaluating the elements of medical decision-making (MDM) for evaluation and management (E/M) services, a chest X-ray performed during an office visit is typically included in the overall service rather than billed separately. This means that the interpretation of the chest X-ray is factored into the complexity of the patient’s condition and the provider’s decision-making process. When providers perform diagnostic tests like chest X-rays during an E/M visit, these tests contribute to the assessment of the patient's problem and the management plan. The results of the chest X-ray are used to inform clinical decisions without necessitating additional billing, as they are part of the E/M service provided. Therefore, it is appropriate to view the chest X-ray as a component that enhances the MDM value rather than a standalone service requiring separate reimbursement. Additionally, when considering coding and billing practices, including such diagnostic procedures in the overall E/M service avoids duplicates and streamlines the billing process, reflecting the actual nature of the care provided to the patient during that visit.