New Patients with out an exam???

We have a 20 yr old that comes into our office as a New Patient and is just wanting to discuss birthcontrol to regulate her menses. The doc writes in the chart "Exam Deferred", can I still bill a New Pt 9920X or would I use the counseling codes 9940X. The doc. did write that she counseled her on different types of birthcontol and I would use dx codes v25.3, 625.9, 625.3, 625.0.. any thoughts. We have this alot due to OB/GYN, more with 15-17 yr olds not having or wanting an exam and I am stuck.

re: New Patients with out an exam???

They do get an exam! Vitals are taken (I hope). But I would code this using either the preventive codes or use time as a determinant for the E&M codes and be sure the doc documents time spent. And I would encourage "exam not indicated due to lack of sexual activity" rather than "deferred"