Sally Panther, who is applying to be a foster parent, is an established patient who presents to her primary care physician because of headaches she's been experiencing and debilitating muscle spasms in her shoulders and neck

Sally is sure that her symptoms are related to the stress surrounding her foster parent application, and more than half of the 45-minute visit is spent in counseling Sally regarding stress reduction techniques and in coordinating care for the reduction of the muscle spasms. During the visit, Sally shows her doctor the state-ordered paperwork that her caseworker has required her to fill out. Sally's primary care physician documents a detailed history, performs a detailed physical examination, and documents the medical decision making of low complexity, as well as the subjects addressed during the counseling and coordination of care. Which of the following best reflects the performed E/M service and modifier usage? a. Office or other outpatient service; established patient; level 4 with modifier 32
b. Office or other outpatient service; established patient; level 4 with no modifier
c. Office or other outpatient service; new patient; level 2 with modifier 32
d. Office or other outpatient service; established patient; level 3 with no modifier

b) Office or other outpatient service; established patient; level 4 with no modifier