Pediatric Coding Alert

Question: The parent of one of our established patients is coming in for a consultation. The patient was supposed to come in today, but has been admitted to the hospital because he is causing harm to himself. The parent wants to still come in and have the consultation with the physician, without the child being present. How do I code for this?  

Michigan Subscriber

Answer: You should report a code from the 99212-99215 series based on time spent counseling and coordinating the patient’s care. As the descriptor for these E/M codes says, the visits in this category can involve time “with the patient and/or family.”

Keep in mind that if you see the patient in the hospital that day to treat his self-harm, you should not bill a separate E/M service when you meet with the parents. If the parent visit occurs on the hospital unit, you can incorporate the time spent counseling and coordinating care in your hospital billing, including the possible use of prolonged services codes if the time is extensive.