Optometry Coding & Billing Alert

Question: Is there a code I can use for writing a prescription? If so, may I report it in addition to an E/M service or when a patient calls in and I simply write a prescription for the patient to pick up at the front desk?


New Jersey Subscriber

Answer: There is no CPT code that you should report when you write a prescription for a patient. CPT specifically includes writing prescriptions as part of an E/M service. You should consider prescription writing as part of the cost of seeing patients.

Coding solution: If you or a technician sees the patient, you should report the appropriate E/M code--for example, an established patient code (99211-99215, Office or other outpatient visit for the evaluation and management of an established patient ...).

But you must meet incident-to guidelines to report 99211 (Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician), which means there must be a plan of care with medical necessity for the technician to see the patient. There must also be documentation to support the visit, and you must be immediately available in the office suite.

But if the only reason the patient is coming into your office is to pick up a prescription and you do not see her, you shouldn't report an E/M service. Note, however, that this service, if documented, may accrue to the medical decision-making of a subsequent E/M service.

Diagnosis option: There is a diagnosis code, V68.1 (Issue of repeat prescriptions), which might be appropriate for you to report.