Dermatology Coding Alert

Question: Our dermatologists see acne patients for follow-up isotretinoin visits. During these visits, we monitor the drug administration as our primary focus and the course of the disease secondarily. Is there an advantage or a disadvantage to billing on the V code for the isotretinoin monitoring?

Texas Subscriber

Answer: You should code the appropriate E/M service (99211-99215) as long as your documentation justifies it. Even though your physicians see the patients to monitor the drug therapy, the physicians provide the E/M services for the disease follow-up as well.
 
You should code the acne first (706.1, Other acne) and then V58.69 (Long-term [current] use of other medications) or V58.1 (Drug therapy [maintenance]), depending on the individual circumstances and the extent of the patient's drug therapy.