Accutane urine pregnancy tests

LWright11

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We see quite a few Accutane acne patients. As anyone who deals with Accutane knows, female patients must take urine pregnancy tests every month. These tests in our office are administered and read by the nurse before the monthly drug counseling and the Prescription is given. Are we able to code and charge for the pregnancy tests we administer or is that considered part of the drug treatment plan and under the medical visit for the acne condition? What about the actual monthly drug counseling? I think we actually can charge for them, but I'm not sure which codes would apply and result in optimum payment. Any ideas or thoughts?

Thanks!
 

sbicknell

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Accutane requires close monitoring and patients must sign a form stating they are not pregnant and don't intend to get pregnant while taking this RX.

If the patient is seeing the Nurse only:
You can code for preg test. Are you saying the nurse does a 81025 with V72.41 in the office. Depending on the nurse documentation could also code the 99211-25 with the 81025

If the nurse is doing the testing as part of the physician visit for him to order or refill the Accutane, then can code for the lab test only. Nurse services would be included in the Physician E&M

Who's doing the drug counseling? If the physician is as part of his visit, then it is included. Depending on time spent counseling and documentation, can code the physician visit based on time

If the counseling is a separate encounter, then look at preventive or risk reduction code of 99401 etc
 

mbenda

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Is this still accurate? We are looking into administering the pregnancy test to Accutane patients when they come in for their monthly drug counseling appointment. They will be seen by a PA, NP or MD. We would bill the E&M code with a 25 modifier and the 81025.
 
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