Wiki ?

[RebeccaB]

Hi Everyone...One of our physicians had an office visit with only the patient's family to discuss pt's care options..patient was not present, is a medicare patient
I know there is no billable E/M service without the patient being present...My question is there anything that would be billable in this situation ?

Thanks
Rebecca

 

[debbiesom]

You cannot bill any insurance for this type of service. You could have charged a fee up front for the family to have a consultation with the doctor but now that it is already done I would not bill after the fact. The fee should have been told to family prior to the appointment and to be paid at time of service.

 

[csperoni]

Well, you certainly cannot bill Medicare for this service. It is possible (although highly unlikely) a private carrier does not follow the Medicare guideline of face-to-face requirement to bill an E&M.

There is a code under psychotherapy 90887 "Interpretation or explanation of results of psychiatric, other medical examinations and procedures, or other accumulated data to family or other responsible persons, or advising them how to assist patient." I have yet to encounter an insurance that will pay for 90887.

In our practice, we encourage the family to bring the patient if possible. If not, we just provide the service knowing we will not get paid. It is not something that happens frequently and consider it a good deed for the day. For our own purposes, we do code a 90887 just to track that the service was provided.