Look at the instructions in parenthesis at the end of codes 95250 and 95251. They both state, "Do not report ... in conjunction with 99091. If you look at the use of code 99091, it states, "Code 99091 should be reported no more than once in a 30-day period to include the physician or health care provider time involved with data accession, review and interpretation, modification of care plan as necessary (including communication to patient and/or caregiver), and associated documentation.
It appears that unless an evaluation and management service was performed, it cannot be billed, and, codes 99250 and 99251 already include the time he spent communicating the results to the patient. I don't think an E & M is appropriate for this situation. That's just my opinion.
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