Urology Coding Alert

Reader Questions:

Stop Looking for Prescription Service Code

Question: My physician heard that there's a code we can bill and be paid on for the writing of a prescription. Is there such a code and, if so, can we report it in addition to an E/M service and/or when a patient calls in and the physician simply writes a prescription?

New Jersey Subscriber Answer: There is no CPT code that you should report when your physician writes a prescription for a patient. CPT specifically includes writing prescriptions as part of an E/M service. Your office should just consider prescription writing as part of the cost of seeing patients.
 
Coding solution: If someone in your office, either the physician or a nurse, is seeing the patient, you should report the appropriate E/M code -- for example, an established patient code (99211-99215, Office or other outpatient visit for the evaluation and management of an established patient ...).
 
But if the only reason the patient is coming into your office is to pick up a prescription and neither a physician nor a nonphysician practitioner sees her, you should not report an E/M service. But this service, if documented, may accrue to the medical decision-making of a subsequent E/M service.
 
Diagnosis option: There is a diagnosis code that might be appropriate for you to report -- V68.1 (Issue of repeat prescriptions). You should use V codes to provide additional clinical information to an insurer, whether it's Medicare or a private carrier.
 
V codes do not really increase your payments but instead paint a clinical picture of the patient's condition.

-- Answers to Reader Questions and You Be the Coder contributed by Michael A. Ferragamo, MD, FACS, clinical assistant professor of urology, State University of New York, Stony Brook; and Morgan Hause, CCS, CCS-P, privacy and compliance officer for Urology of Indiana LLC, a 31-urologist practice in Indianapolis.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Urology Coding Alert

View All