Wiki Established patient E&M coding when patient not present

[sbunting]

Can we bill an established patient E&M when the encounter only has a family member and the patient was not present? I watched a coding podcast from a Terry Fletcher where she says we cannot anymore, but when I read at the beginning of the E&M guidelines it does state that "these guidelines are for services that require a face to face encounter with the patient and/or family/caregiver." I am looking for clarification as we currently have a scenario where the patient was not present, only the mother of the patient.

 

[rstroup]

Unless there is an upcoming change I haven’t read about yet, the most recent resources from AMA and CMS do not specify that the patient must be present with the family/caregiver in order for the provider to get credit for the visit.

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Ryan Stroup, CPC