You can bill an E&M with a well visit. The notes must show the well visit and document, and then the medical issue and document. The level (99213) must be for the amount of time spent on the problem and cannot include the time for the well visit. I know E&Ms are not solely based on time, but my point is if the appointment took a total of 45 minutes you can't bill the 99215 since part of that time was on the well visit. Might want to consider the 25 modifier as well to indicate the problem was separate from the well visit.