Neurosurgery Coding Alert

Question: I heard that there's a code we can bill (and be paid for) to indicate when our physician writes a prescription. What is it, and can we report it in addition to an E/M service? How about when a patient simply calls and the physician writes the prescription?

Florida Subscriber

Answer: You may be referring to V68.1 (Issue of repeat prescriptions). But if the only reason the patient comes in is to pick up a prescription and the neurosurgeon does not see her for a documented E/M service, you cannot bill an E/M code.

In fact, CPT specifically includes writing prescriptions as part of an E/M service. This is just part of the cost of seeing patients, much like office supplies. There is no CPT code for writing a prescription that payers will reimburse.

Note: Prescription drug management supports a "moderate" level of risk, according to the table of risk found in the E/M documentation guidelines. Although not a separately billable service, prescription drug management can help to support a higher service level.

For example, you should associate a moderate level of risk with a level-four established patient office visit (99214, Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: a detailed history; a detailed examination; medical decision- making of moderate complexity).

-- Answers to You be the Coder and Reader Questions were reviewed by Gregory Przybylski, MD, director of neurosurgery at the New Jersey Neuroscience Institute, JFK Medical Center in Edison, N.J.