Neurology & Pain Management Coding Alert

Question: I heard that there's a code we can bill (and be paid for) to indicate when our physician writes a prescription. What is it, and can we report it with an E/M service? What if the patient simply calls and the physician writes the prescription?

Florida Subscriber

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

Insurance carriers consider prescription writing as part of the cost of seeing most patients, much like office supplies. There is no separate CPT code for writing a prescription that carriers will reimburse.

Note: Prescription drug management supports a "moderate" level of risk, according to the table of risk found in CPT's E/M documentation guidelines. Although not a separately billable service, prescription drug management can help to support a higher service level.

You should associate a moderate risk level with a level-four established patient visit (99214) if the physician also documents multiple diagnostic or management options at this visit or orders or reviews a moderate number of tests.