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Ophthalmology and Optometry Coding Alert

Reader Questions:

Face-to-Face Is a Must for Medicare

Published on Tue Oct 23, 2007

Question: What is the best way to code for a family consult when the patient is not present (no face-to-face contact)? The patient is a nursing home patient whom our ophthalmologist saw, and the family wants to come in to discuss the best care. South Carolina Subscriber Answer: If this is a Medicare patient, you won' be able to charge for the consultation. Medicare only pays when the patient is present, and you won't find a way around this. You can bill the family for the visit, or you can have the family present at the nursing home with the patient in the room when the physician performs the consult. This would not be a coding "consultation" but rather a nursing home visit (99334-99337). The important thing in this situation is that the physician has face-to-face contact and evaluates the patient along with discussing treatment options with the family. -- Advice for You Be the Coder and Reader Questions provided by Maggie M.
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