Wiki New Pt Contraceptive Mngt E/M

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Jeannie171717

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We have a discussion going at our office over how to code for a New young patient who comes in to start birth control only. Usually our CNM's do not do an exam, but spend well over 1/2 hour with the pt. discussing risks, etc. as well as doing a lengthy history. Many times these young ladies had already had their complete annual physical at their family doctor or pediatrician before coming to us. Since these are New patients and there is no exam (or very limited heart & lungs ck) we think the correct code would be 99202. It is so frustrating because we spend so much time and there is medical decision making. Does anyone have any advice on this topic? I can't find anything listed on the ACOG website.
 
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We bill the codes from 99401-99404, Preventive Medicine, Individual Counseling. The code description indicates, "Preventive medicine counseling and risk factor reduction interventions will vary with age and should address such issues as family problems, diet and exercise, substance abuse, sexual practices, injury prevention, dental health and diagnostic and laboratory test results available at the time of the encounter".

Unless OCs are being prescribed for a medical reason other than contraception, we don't bill an E&M office visit.
 
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