APMA urges members to consider the following when using “prescription drug management” to satisfy the “Moderate” threshold of the “Risk of Morbidity from Additional Diagnostic Testing or Treatment” element of evaluation and management (E/M) level selection:
- “Prescription drug management” is meant to represent any management of a prescription. Management includes not only initial prescription, but also the decision to continue, modify, or discontinue a prescription.
- For “prescription drug management” to have occurred, the drug managed must require a prescription by the FDA. Over-the-counter medications and products do not require a prescription and, therefore, their management cannot be considered “prescription drug management.” This category includes over-the-counter medications that may be available in a different prescription form/quantity/dosage under the same name.
For other coding updates and advice, visit www.apma.org/coding. If you have questions or concerns, contact the APMA Health Policy and Practice department at healthpolicy.hpp@apma.org.
Reference: 2022 CPT Professional. Current Procedural Terminology (CPT®) is copyright by the American Medical Association. All rights reserved.