Otolaryngology Coding Alert

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: CPT does not include a procedural code for writing prescriptions. You may be referring to the diagnostic code V68.1 (Issue of repeat prescriptions). If the only reason the patient comes in is to pick up a prescription and the otolaryngologist does not see her for a documented E/M service, you cannot bill an E/M code.

CPT specifically includes writing prescriptions as part of an E/M service. This is part of the cost of seeing patients, much like office supplies.

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.
 
When it's medically necessary and a history or exam is documented, you could associate a moderate level of risk with a higher level of office visit, if warranted by the documentation.

You Be the Coder and Reader Questions were reviewed by Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CHCC; and Charles F. Koopmann, MD, MHSA.