Primary Care Coding Alert

Question: Our physician and physician assistant are educating some patients on diabetes, exercise, and nutrition at our practice twice a month. The plan is to bring the patients in at 4:45 to workup the patient, and start the group session at 5 p.m. for about 45 minutes to an hour. Can practices report these services? Will carriers pay for them?Michigan Subscriber Answer: You have a few options depending on what insurers cover. Option 1: For the workup, report the appropriate level E/M service, such as 99212 (Office or other outpatient visit for the evaluation and management of an established patient ...). Use physician group education codes for the 45-minute counseling session. Since the education is in a group setting provided by a physician or non-physician practitioner (the physician assistant [PA]) and the patients have an established illness (diabetes), the sessions fall under 99078 (Physician educational services rendered to patients in [...]