Wiki CPT for consultation with family member of deceased patient.

abbyakinleye

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Hello,
I have a scenario whereby the patient is deceased. His daughter had a consultation with his physician to go over why his death was sudden, 15/30min spent with the duaghter and documented. What will be the CPT® and DX for this scenario?
Thank you.
 
Is the daughter also a patient at the the facility? If not, I would not think the visit would be billable at all. If yes, then I might code v62.82 or V61.07 with some sort of accompanying anxiety code (300.00, maybe??) at a 99212 level.
 
Your claim will be denied if you bill the patient's insurance after their date of death. And without a face-to-face with the patient, some payers won't even consider a family consultation, even if they're still alive.

My suggestion is to bill the patient's family--either directly or through their own insurance. Due to the nature of the discussion, this might be best provided as a pro-bono service, however it's your call.

If you decide to bill the patient's family memeber's insurance, use the V65.19, consultation on behalf of another, since it's a discussion about the events leading to the patient's death, not bereavement of the family. Also, I would never recommend that you give a mental health diagnosis code to any family member that you don't have a clinical relationship with just because you're discussing their family member's demise. Without a psychiatric evaulation, appending such a diagnosis code is inappropriate. That diagnosis code will remain on their medical record, whether it's valid or not. My two cents.
 
what Pam has said is excellent advice and exactly the same thing I would have said. It is just wrong to try to give a patient or even family member a disease just so that you can get a reimbursement. There are some things that a payer will not pay for. I even wonder about the V65.19 as they are not seeking advice on BEHALF of another since the other individual has passed on. This implies that you are wanting to obtain information to better care for the individual.. and clearly this is not the case. I would wash this away and move on, but as Pam said only my opinion.
 
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