Orthopedic Coding Alert

Reader Questions:

Include Prescription Writing in E/M

Question: I recently attended a seminar in which the presenter said we can bill a particular code whenever our physician writes a prescription. What is it, and can we report it in addition to an E/M service? How about when a patient simply calls and the physician writes the prescription?

Florida Subscriber Answer: You may be referring to V68.1 (Issue of repeat prescriptions). But if the only reason the patient comes in is to pick up a prescription, and the orthopedist does not see her for a documented E/M service, you cannot bill an E/M code.
 
In fact, CPT specifically includes writing prescriptions as part of an E/M service. This is just part of the cost of seeing patients, much like office supplies. There is no CPT code that payers will reimburse for writing a prescription.
 
Note: Prescription drug management supports a -moderate- level of risk, according to the table of risk found in the E/M documentation guidelines. While not a separately billable service, prescription drug management can help to support a higher level of service if you do see a patient for a documented E/M visit that includes prescription management. You should associate a moderate level of risk with a level-four established patient office visit (99214).  
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Orthopedic Coding Alert

View All