tci Medicare Compliance & Reimbursement - 2020 Issue Q3

Reader Question: Sidestep Medication Management Coding Snafus With These Tips

Question: What codes should we use for attention deficit disorder (ADD)/attention-deficit hyperactivity disorder (ADHD) medication follow-ups? We used an evaluation and management (E/M) code and the claim was denied; however, using a preventive medicine code doesn’t seem appropriate. What would you suggest? SuperCoder Subscriber Answer: When the follow-up just involves medication management, 99401-99404 (Preventive medicine counseling and/ or risk factor reduction intervention(s) provided to an individual (separate procedure) …) are not appropriate. That’s because the codes “are used for persons without a specific illness for which the counseling might otherwise be used as part of...

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