CMS Pub. 100-02, ch. 15, § 80.6.4

Additional Tests

(Rev. 80; Issued: 01-11-08; Effective: 01-01-03; Implementation: 11-19-07)

The following applies to an interpreting physician of a testing facility who furnishes a diagnostic test to a

beneficiary who is not a hospital inpatient or outpatient. The interpreting physician must document

accordingly in his/her report to the treating physician/practitioner.

Test Design

Unless specified in the order, the interpreting physician may determine, without notifying the treating

physician/practitioner, the parameters of the diagnostic test (e.g., number of radiographic views obtained,

thickness of tomographic sections acquired, use or non-use of contrast media).

Clear Error

The interpreting physician may modify, without notifying the treating physician/practitioner, an order with

clear and obvious errors that would be apparent to a reasonable layperson, such as the patient receiving the

test (e.g., x-ray of wrong foot ordered).

Patient Condition

The interpreting physician may cancel, without notifying the treating physician/ practitioner, an order

because the beneficiary’s physical condition at the time of diagnostic testing will not permit performance of

the test (e.g., a barium enema cannot be performed because of residual stool in colon on scout KUB;

170.5PA/LAT of the chest cannot be performed because the patient is unable to stand). When an ordered

diagnostic test is cancelled, any medically necessary preliminary or scout testing performed is payable.