Neurology & Pain Management Coding Alert

Question: My neurologist believes there is a code specifically for writing a prescription. Is there such a code, and if so, may I report it in addition to an E/M service code?

New Jersey Subscriber

Answer: There are no CPT codes expressly for writing prescriptions. CPT includes prescriptions as part of the medical decision-making key component of the E/M service being performed, and payers include the service in the E/M code reimbursement.

Be clear on E/M codes: If a patient comes into your office only to pick up a prescription, you may not report an E/M service if a provider does not see the patient for a medically necessary service. If your neurologist or nonphysician practitioner does encounter a patient, use code 99211-99215 (Office or other outpatient visit for the evaluation and management of an established patient . . .).

Do you need a V code? Code V68.1 (Issue of repeat prescriptions) may be appropriate as a primary diagnosis code to support medical necessity for the E/M code.

-- Clinical and coding expertise for You Be the Coder and Reader Questions reviewed by Marvel J. Hammer, RN, CPC, CCS-P, ACS-PM, CHCO, owner of MJH Consulting in Denver.