Billing 90862 with E/M code

Grand Rapids, Michigan
Best answers
I have a family practice client that would like to add 90862 (med check) to their EM visits. From what I have read, this is inappropriate billing. Unless they are only coming in for med checks (for ADD or depression), is the only time you can bill this. I feel that this would be included in the office visit. I would like input on this or where I can get it in "black and white" so I can show the physicians the proper way to do this.

Thank you!
Although CCI Edits will get you a general idea, my comments won't be "black and white" either.

CPT conventions include the service of 90862 in an E/M. Take an audit sheet for E/M and show your physician the Risk Table--Prescription Meds are included there, so it's a "bundled" service.

What your physicians are "wanting" to do is unbundling, and there's plenty of commentary around on that practice.

Good luck.