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Pediatric Coding Alert

Reader Questions:

Sometimes Mom-to-be Charge Is OK

Published on Tue Jul 13, 2010

Question: A new mom-to-be visited our office because her doctor expects a complicated delivery and anticipates problems with the baby. The pediatrician spent a lot of time counseling the mom and reviewing medical records. Our office doesn't usually charge for "meet the doctor" visits, but this meeting was more involved than normal. Can we bill the visit to insurance or the patient?Idaho SubscriberAnswer: The unborn fetus is not yet a patient for whom you can have a face-to-face encounter. Instead, the visit you describe qualifies as an office consultation on the mother, which you report as 99243 (Office consultation for a new or established patient, which requires these three key components: a detailed history; a detailed examination; and medical decision making of low complexity). List "consultation" as the type of service and send a report back to the obstetrician.Report the service based on the pediatrician's time spent counseling, where she [...]
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