Primary Care Coding Alert

Reader Question:

Consider Patients and Provider for 99078 vs. 98960-98962

Question: Our physician wants to implement group patient education meetings, when he'll bring together several patients with the same diagnoses for an educational lecture/meeting. He suggested we could bill with 99078. What's your advice?Kansas SubscriberAnswer: The appropriate code choice depends on how your provider structures the meetings and how many patients are present.Option 1: If the physician plans and presents the information, you can submit 99078 (Physician educational services rendered to patients in a group setting [e.g., prenatal, obesity, or diabetic instructions]) as he suggests. Note that 99078 is not a time-based code and can be submitted for each patient present during the session. Not all payers reimburse for 99078, however, so check guidelines before making assumptions regarding payment.Option 2: If a non-physician provider leads the session, you'll report different codes based on the number of patients present. Choices include 98960 (Education and training for patient self-management by a qualified, [...]
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