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Pediatric Coding Alert

Reader Questions:

Weigh Your MD Diabetes Education Options

Published on Fri Aug 28, 2009

Question: A pediatrician and PA are educating some parents on diabetes, exercise, and nutrition. The plan is to bring the patients in at 4:45 to workup the patient, and start the group session at 5 p.m. for about 45 minutes to an hour. Can practices report these services? Will carriers pay for them? North Carolina Subscriber Answer: You have a couple options depending on what insurers cover. Option 1: For the office visit (workup), report the appropriate level E/M service, such as 99212 (Office or other outpatient visit for the evaluation and management of an established patient ...). Use physician group education codes for the 45-minute counseling session. Since the education is in a group setting provided by a physician or nonphysician practitioner (the physician assistant [PA]) and the patients have an established illness (diabetes), the sessions fall under 99078 (Physician educational services rendered to patients in a group setting [...]
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