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I would bill the e&m but what would you use as the diagnosis on the birth control visit? If the patient has no medical issue like dysmenorrhea or menorrhagia. Wont the Z30.011 deny for Z code with office visit code?
 
It would depend on the documentation. In order to bill both WWE 99384-99397 and E&M 99202-99215 with mod -25, you must have a significant, and separately identifiable E&M visit. The most clear cut way from a coding perspective is 2 separate notes. If you don't have that, take the one note and cross out EVERYTHING related to the preventive - there's your separately identifiable. If what is left is significant, then level E&M based on that. If all you have left is a line stating "Lo Loestrin with 5 refills", then I would not bill an E&M.
Link your Z01.419 to 99384-99397 and Z30.011 to 99202-99215. I don't think you would have an issue with Z30.011 on an E&M, but that would be a carrier decision. For example, a patient who had a WWE 5 months ago might come in today just for initial OCP, which would clearly be coded as E&M with Z30.011.
 
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