counseling with family

VRcoder29

Guru
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I need help, I have a Dr wanting to bill an E/M 99212-99215 for a patient's family coming in and talking regarding the patient for over 30 minutes. The patient was not present. NOW , we can't bill this to begin with because it is a Medicare patient and the patient must be present. However, is there another E/M code I can use regarding family couseling? I know it will not pay but I am trying to "SATISFY" this Dr , because she is mad she can't bill for it.
Help me anyone

THANKS
 

meganpoelzer

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family counseling

That's a tough one! I don't think you can bill for the family coming in to talk about the patient. You wouldn't be able to bill the patient's insurance or the patient since they weren't present, and I don't think you can bill the family either.

Megan Barber, CPC
 

sgoodknight

Contributor
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South Bend
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Hi there,

This question has come up numerous times at our practice.

The correct code would be 99499. You would just bill one of the family members. The doctor would need to determine the fee. A suggestion would be to compare it to 99214.

Since you didn't make the family aware ahead of time there would be a charge for the encounter, you may have difficulties determining which family member to bill and from whom to receive reimbursement.

I agree that Medicare CANNOT be billed and neither can the patient.

Sandy Goodknight, CPC, CPMA, CEMC
Indiana
 
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