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Billing for family meeting and IV infusion on same day

L

lisamarhea

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One of the doctors that I work for saw a patient's family to discuss the pt's new diagnosis of MS. On the same day, the patient was having an infusion done in the office, but was not in the room. The doctor states he spent an hour discussing the pt's diagnosis with the family, and wants to know if this is billable. (FYI: Pt's insurance is Anthem, PHP)
Here's what I'm thinking, and please someone let me know if I'm correct: We can bill the established office visit code 99215 because it states "patient and/or family" and more than 50% of the time spent was regarding counseling/coordination of care. I would also put a modifier 25 on it because I'm billing out the infusion on the same day.
There wouldn't be any use of the "prolonged service codes", correct? Because the time would only be 20 minutes longer than the amount of time listed for the 99215 code.

Thanks for anyone's reply! :)
 
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