• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.
  • We're introducing new features and a new look to make the forums easier to use and more valuable to you. See what's new and let us know what you think!

CPT for consultation with family member of deceased patient.

abbyakinleye

Networker
Messages
27
Location
Laguna Niguel
Best answers
0
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.
 

erjones147

Expert
Messages
385
Best answers
0
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.
 

Pam Brooks

True Blue
Local Chapter Officer
Messages
2,061
Location
Dover Seacoast New Hampshire
Best answers
0
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.
 

mitchellde

True Blue
Messages
13,308
Location
Columbia, MO
Best answers
0
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.
 
Top