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E/M charge for patient not present!

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Can a patient/insurance be billed an E/M service, if a family member came in to discuss behavioral issues of the patient with the provider without patient being present?
 

btadlock1

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Can a patient/insurance be billed an E/M service, if a family member came in to discuss behavioral issues of the patient with the provider without patient being present?
Without knowing the details, I'd advise you to check out 90846, or 96155. Those are the only applicable codes I could find, that don't require the patient's presence. Hope that helps! ;)
 

pamsbill

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Actually, CPT allows it in the description of an E&M office visit code if you code strictly on the time element:

"...Physicians typically spend X minutes face-to-face with the patient and/or family."

Medicare never allows it. You would have to check with the specific commercial carrier to see if it allowed by them though. Most practices make the family pay at the time of service and consider it a private-pay situation.

PJM
 
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