The EDC Analyzer™ reviews all line-level services on the claim to identify diagnostic tests that fall into each of the following categories:
Each category carries an extended cost weight. The EDC Analyzer™ adds together the weights for each unique category of tests found on the claim to determine the overall extended cost weight. For example, if 2 laboratory tests and 3 X-rays are billed, the EDC Analyzer™ will count the laboratory tests as one and the X-rays as one.
Extended cost weights were calculated for each category based on the level of ED resources expended (including staff time) to note orders, communicate with the patient and staff, and follow up as needed.
Below are some examples showing how the EDC Analyzer™ assigns an extended cost weight based on a diagnostic test:
|Diagnostic Category||CPT Code||Code Description||Extended Cost Weight*|
|Lab||61070||PUNCTURE OF SHUNT TUBING OR RESERVOIR FOR ASPIRATION OR INJECTION PROCEDURE||***|
|Lab||62270||SPINAL PUNCTURE, LUMBAR, DIAGNOSTIC||***|
|CT/MRI/Ultrasound||62284||INJECTION PROCEDURE FOR MYELOGRAPHY AND/OR COMPUTED TOMOGRAPHY, LUMBAR (OTHER THAN C1-C2 AND POSTERIOR FOSSA)||***|
|EKG/RT/Other Diagnostic||62302||MYELOGRAPHY VIA LUMBAR INJECTION, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION; CERVICAL||***|
|EKG/RT/Other Diagnostic||62303||MYELOGRAPHY VIA LUMBAR INJECTION, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION; THORACIC||***|
|Lab||69100||BIOPSY EXTERNAL EAR||***|
|Lab||69105||BIOPSY EXTERNAL AUDITORY CANAL||***|
|X-Ray – Plain Film||70010||MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGICAL SUPERVISION AND INTERPRETATION||***|