This is a little sketch - if the question you asked didn't required any additional work (specialized physical exam, detailed history taking, additional medical

This is a little sketch - if the question you asked didn't required any additional work (specialized physical exam, detailed history taking, additional medical decision making), billing for it as a separate evaluation and management visit (as opposed to a preventative visit) isn't kosher. Often people come into their preventative visit wanting to discuss their insulin regimen, blood pressure history or a new acute problem, and this is the situation where the second charge is appropriate.