Prescription Drug Management

[KaylaRieken]

Is telling patients to continue meds prescription drug management? (no refills were given)

 

[Cheezum51]

I would say it is. CPT has said the decision to not change medications or deciding not to proceed with a surgery or other procedure is still considered a management decision for the patient care.

Just because a patient didn't need a refill at the time of the exam, doesn't mean they won't need one next month.

Tom Cheezum, OD, CPC, COPC

 

[KaylaRieken]

Is this written in the CPT book somewhere? What happens if the patient is seen every 3 months or 6 months? that is ok to say this is prescription drug management if that would give them 99214s everytime?

 

[smihm]

Is this written in the CPT book somewhere? What happens if the patient is seen every 3 months or 6 months? that is ok to say this is prescription drug management if that would give them 99214s everytime?

From Medicare

What constitutes prescription drug management?​

Q. During an evaluation and management visit, what constitutes “prescription drug management?”
A. “Prescription drug management” is based on documented evidence that the provider has evaluated medications as part of a service, in relation to the patient. This may be a prescription being written or discontinued, or a decision to maintain a current medication/dosage.
Note: Simply listing current medications is not considered “prescription drug management.”
Source: Program Integrity Department

 

[houmaob1714]

From Medicare

What constitutes prescription drug management?​

Q. During an evaluation and management visit, what constitutes “prescription drug management?”
A. “Prescription drug management” is based on documented evidence that the provider has evaluated medications as part of a service, in relation to the patient. This may be a prescription being written or discontinued, or a decision to maintain a current medication/dosage.
Note: Simply listing current medications is not considered “prescription drug management.”
Source: Program Integrity Department

Can you tell me where you found this on Medicare?

 

[smihm]

Can you tell me where you found this on Medicare?

https://medicare.fcso.com - go under Evaluation and Management - E/M FaQ's- Service Components- its a listed as a question

 

[KaylaRieken]

If my provider is doing a consult in the hospital and says he agrees with ongoing broad-spectrum antibotics while we await culture results, could this be considered prescription management? (moderate decision making)

 

[sivakumar.s]

If my provider is doing a consult in the hospital and says he agrees with ongoing broad-spectrum antibotics while we await culture results, could this be considered prescription management? (moderate decision making)

No, this is not warrant for prescription management. PFA

 

[JulieKasik]

Can you tell me where you found this on Medicare?

https://medicare.fcso.com - go under Evaluation and Management - E/M FaQ's- Service Components- its a listed as a question

Medicare FCSCO is not the same as CMS... I am not sure I would take this at face value.

 

[clongoria95]

I want to say prescription drug management can be different depending on your MAC. I know Notivas considers refilling meds prescription drug management but I've seen other coders/auditors online mention theirs did not (but I couldn't tell you which ones):

4. When can prescription drug management be credited in the medical decision-making risk of complications chart?
Credit is given for prescription drug management when documentation indicates medical management of the prescription drug by the physician who is rendering the service. Medical management includes a new drug being prescribed, a change to an existing prescription or simply refilling a current medication. The drug and dosage should be documented as well as the drug management.
If medications are just listed in patient’s medical record, credit is given for past history.

https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00005056