Wiki Counseling only

[njbrown]

If parents come to office with out child for counseling on cochlear implant and decision to have surgery for child is that a billable service, and If so would you use 99499 unlisted evaluation and management code?

 

[CBLENNIE]

This may be a stupid question, but is there reason you wouldn't use an office E&M 99202-99215 using time spent counseling the parents about their child's potential cochlear implant procedure for leveling the E&M?

 

[njbrown]

This may be a stupid question, but is there reason you wouldn't use an office E&M 99202-99215 using time spent counseling the parents about their child's potential cochlear implant procedure for leveling the E&M

Since patient was not actually with them did not know exactly how to code the visit

 

[lgardner]

you cannot code an E/M without the pt involved.

 

[njbrown]

you cannot code an E/M without the pt involved.

Thank you

 

[njbrown]

you cannot code an E/M without the pt involved.

Could you use would of the counseling codes?

 

[njbrown]

Could you use one of the counseling codes?

 

[lgardner]

I don't believe so.
I am not an expert on this, so maybe someone else will chime in.

 

[njbrown]

I don't believe so.
I am not an expert on this, so maybe someone else will chime in.

thank you

 

[amyjph]

Old AAPC blog post about it: https://www.aapc.com/blog/27912-billing-rules-change-when-the-patient-isnt-present/

Conflicting advice in 2022: https://www.aapc.com/codes/coding-n...eling-when-patient-not-present-172497-article

Seems to come down to payer guidelines, I think some may allow it but you would have to make 100% sure.

Another take: https://www.cmedmgt.com/when-talkin...t=What If the Patient Isn,using the E/M codes.

 

[lgardner]

Old AAPC blog post about it: https://www.aapc.com/blog/27912-billing-rules-change-when-the-patient-isnt-present/

Conflicting advice in 2022: https://www.aapc.com/codes/coding-n...eling-when-patient-not-present-172497-article

Seems to come down to payer guidelines, I think some may allow it but you would have to make 100% sure.

Another take: https://www.cmedmgt.com/when-talking-to-family-about-patient-care-can-i-report-an-em-code-for-that-visit/#:~:text=What If the Patient Isn,using the E/M codes.

yes.
I fell down a rabbit hole with this question.
I was so certain, at first, but there seems to be very different takes on this question.

 

[amyjph]

If there are any peds or geriatric med folks that can chime in, they might be better informed about this scenario. Some of the Medicaid carriers might have a rule.

 

[njbrown]

Old AAPC blog post about it: https://www.aapc.com/blog/27912-billing-rules-change-when-the-patient-isnt-present/

Conflicting advice in 2022: https://www.aapc.com/codes/coding-n...eling-when-patient-not-present-172497-article

Seems to come down to payer guidelines, I think some may allow it but you would have to make 100% sure.

Another take: https://www.cmedmgt.com/when-talking-to-family-about-patient-care-can-i-report-an-em-code-for-that-visit/#:~:text=What If the Patient Isn,using the E/M codes.

Amy thank you I tried to open the second link but for some reason it will not allow me to do so therefore i cannot see the codes that they suggest