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Wiki Billing E & M with Oral Challenge

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I'm looking for guidance on denials we have been receiving from Aetna when billing an E & M with an Oral Challenge. We are an allergist office who follows up regularly with allergy shot patients or patients with multiple issues. It's easier to schedule an Oral Challenge on the same date as a follow-up visit appointment. The provider is documenting his time with the patient OUTSIDE of the Oral Challenge as well as the time that is devoted to it. Is this a coding issue? Any help appreciated.
 
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