It may be included with the E/M visit, depending on the circumstances and the counseling. In addition, there are care management codes that can be used for chronic conditions when the patient is at significant risk of death including exacerbation/decompensation or functional decline. A part of their care management would be counseling for symptom management. An example would be 99487 Complex chronic care management just be sure the required elements are met and be sure to read the guidelines for the correct use of these codes. Care management codes are timed codes and have rules for clinical staff and which practitioners can bill for these services.
Care Management codes are found under Evaluation and Management /Care Management services for Complex and Chronic care management services 99487-99491.
Physicians and the following non-physician practitioners may bill CCM services:
● Certified Nurse-Midwives
● Clinical Nurse Specialists
● Nurse Practitioners
● Physician Assistants
NOTE: CCM may be billed most frequently by primary care practitioners, although in certain circumstances specialty practitioners may provide and bill for CCM.
Here is an MLN article from CMS on Chronic Care Management Services.