Primary Care Coding Alert

Question: We have a diabetic patient who gets a monofilament test once a year. Can we charge for a monofilament test?

Florida Subscriber

Answer: Definitely not. This should be included in the exam portion of the appropriate E/M service (such as 99212-99215, Office visit for the evaluation and management of an established patient ...) done by the family physician. Monofilament test is a test performed to evaluate the peripheral nervous system. This is especially useful in patients with chronic conditions affecting the peripheral nerves (for example, diabetes mellitus). The test aims to elicit response from sensory skin testing with nylon monofilaments in order to verify presence of peripheral neuropathy. As testing for sensory response is a component of a physical examination, the monofilament test should properly be included in an E/M service.

For example, a diabetic patient with poorly controlled blood sugar and with previous history of diabetic neuropathy comes in for an annual exam, which included a monofilament test. This should be coded as:

• 250.62 -- Diabetes mellitus with neurological manifestations; type II or unspecified type, uncontrolled

• 337.1 -- Peripheral autonomic neuropathy in disorders classified elsewhere.