Dermatology Coding Alert

Question: I heard that there's a code we can bill to indicate when our dermatologist writes a prescription. What is it, and can we report it in addition to an E/M service? How about when a patient simply calls and the dermatologist writes the prescription?

Florida Subscriber

Answer: You may be referring to V68.1 (Issue of repeat prescriptions). But if the only reason the patient comes in is to pick up a prescription, and the dermatologist does not see her for a documented E/M service, you cannot bill an E/M code.

CPT specifically includes writing prescriptions as part of an E/M service. This is just part of the cost of seeing patients, much like office supplies. There is no CPT code that payers will reimburse for writing a prescription.

Note: Prescription drug management supports a "moderate" level of risk, according to the table of risk found in the E/M documentation guidelines. While not a separately billable service, prescription drug management can help to support a higher level of service when your dermatologist does see the patient for a documented E/M visit that includes prescription management. You should associate a moderate level of risk with a level-four established patient office visit, 99214.

Technical and coding advice for You Be the Coder and Reader Questions provided by Pamela Biffle, CPC, CPC-I, CCS-P, CHCC, CHCO, owner of PB Healthcare Consulting and Education Inc. in Watauga, Texas.