Wiki Billable code meeting w NH pt's family

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ivygirl18@hotmail.com

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Hello,

I need some help. Is there a billable code to use when meeting with NH patient's families without the patient present? The patient cannot participate in the meeting due to the patient's condition(s). End of life planning needs to be discussed. If not, is this a charge that can be billed directly to the family?

Thank you,

Abby Ronco-Hopkins, CPC, CPMA
 
Code 90887 or based on time, depending on location of meeting

CPT 90887 is under the psychiatric services heading, but the description states:
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.
Unfortunately, I have yet to encounter an insurance that will pay for the services. So, it's billable, but apparently not payable. :( If you so wished, there is nothing I am aware of to prevent you from charging the family members for the meeting. If you were charging the patient, you should get an ABN, but the patient is not even present, so it does not apply.

You may be able to code standard visits based on time, depending on where the family meeting takes place. If it's in the office (outpatient), then you can only code face-to-face time with the patient, so standard E&M doesn't apply and 90887 would. For inpatient AND NURSING HOME, time is measured using face-to-face with patient as well as time spent on the unit caring for the patient. So, if the physician meets the family in the nursing home, and documents the amount of time, you may code based on time even if the patient is not present in the room.

In our practice, we schedule those family meeting appointments based on whatever location least disrupts the physician's schedule, well aware that we will write off denied charges of 90887 in the office.
 
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