Wiki E/M Coding Help

WHAUN

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Question 1: A patient has some diffuse AKs that my provider is noting as a chronic illness with exacerbation, progression, or side effects of treatment and she is prescribing 5FU cream. This patient also has (newer, non-diffuse) AKs elsewhere on the body that are not exacerbated/progressed like the other spots and she treated these with liquid nitrogen. Can she call these AKs an acute, uncomplicated illness or injury for a 99214 E/M? Basically, my question is can we use the chronic illness w/ exacerbation/progression AND the acute illness for the same AK diagnosis?

Question 2: Can we count a prescription for cosmetic purposes toward the E/M level? Patient was seen for medical visit but also discussed cosmetic wrinkles at the appointment. She wanted a tretinoin Rx for her wrinkles. I know they went over the rx details with her but it this considered prescription drug management and can count toward E/M?

Any help is appreciated!!
 
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