Neurology & Pain Management Coding Alert

Question: When one of our providers administers oral pain medication such as acetaminophen, aspirin or ibuprofen in the office, can I code separately for it? The H0333 looks like a possible candidate, but is it appropriate to use the code in this context?

North Dakota Subscriber

Answer: No, you should include the administration of these drugs in the related evaluation and management (E/M) service, which you’d report with a code from the 99201 (Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: a problem focused history; a problem focused examination; straightforward medical decision making …) through 99215 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: a comprehensive history; a comprehensive examination; medical decision making of high complexity …) code set.

H0033 (Oral medication administration, direct observation) is in the alcohol and drug abuse treatment services. Some private health insurers are using the code for reporting services such as giving the patient an opioid medication to treat opioid addiction in the privacy of a physician’s office. The codes are not for use when you administer drugs such as acetaminophen, aspirin, or ibuprofen, however.