Bolster Rx Management Documentation
Answer: CPT® includes writing prescriptions as part of an E/M service. This is just part of the cost of seeing patients, much like office supplies. There is no specific code that payers will reimburse for writing a prescription.
Note: If you review the Table of Risk in the 1995 or 1997 E/M Documentation Guidelines, you’ll see “Prescription drug management” designated as “Moderate” level of risk under “Management Options Selected.” This is how prescription drug management can influence your E/M level.
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Best practice is for the provider to document actual management of the prescription. For example, if the cardiologist is renewing a cholesterol-related prescription, the plan of care may state that the patient has been tolerating the current dosage well and it is keeping her numbers where they need to be, so the physician is renewing the prescription. As another example, the physician may state that she’s choosing a specific cardiovascular drug because it is safer in combination with the patient’s diabetes medication.
Tip: ICD-9 includes V68.1 (Issue of repeat prescriptions), but you shouldn’t report V68.1 with an E/M code if the only reason the patient comes in is to pick up a prescription. Without face-to-face time and an actual evaluation and management service, you should not bill an E/M code.
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