This is really subjective...first I consider the problem...and if it really took extra time...did it really go "above and beyond"? If at this point I think maybe, I make a copy of the documentation and cross out everything that would belong to the preventative coding. Whatever is left I use to audit for a separate e/m code. At this point there is either enough to justify an extra charge, or there's not. Ideally, there really should be a separate note! I find the "extra" work, is really not that extra...especially if it is a finding as a result of the exam.
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