e/m and ICD-10 codes for Prescription and precautions to take for travel outside US

[MHira]

This New Pt. comes to get prescriptions for travelling outside country. Expanded history, Detailed Exam, Moderate MDM. Patient got Tdap shot, Vivotif ( live oral vaccine), and prescriptions order for Cipro, Omnicef, Malarone to take along during travel. Dr. discussed vaccines, antibiotics and travel illness and medications.

For e/m code
would I code as new patient (99202) or consultation e/m code (99242) along with 90715, 90471 ?

and what would be ICD-10 codes?
I'm looking at Z76.89 or Z71.9 along with Z23 or there is any other code?

Thanks
Meena

 

[thomas7331]

I would advise against billing a new patient or consultation code for this service. Those are 'sick' or 'problem' visit codes that require a chief complaint. What you're describing is really a preventive care service. I don't know of a code for a this, but most payers do not cover travel-related evaluation or counseling and travel medicine clinics I'm familiar with always require that this be paid by the patient. If the travel is work-related, the patient may submit it to their employer for reimbursement. The vaccine itself may or may not be covered by the patient's preventive care benefit though.