Wiki Family Meeting when patient not present

[karenhulka]

I have a situation that with the patient's permission, the Dr met with his wife and daughter to discuss the patient's prognosis and treatment options. The patient was not present at this meeting. I'm not sure how to code this meeting, I thought there was a CPT code for family meeting but only find one under psychotherapy, or should I use a E/M visit code? Also is there a specific ICD10 code for this? or should we use the patient's dx code?

 

[daragan]

We have always billed an E/M visit and with ICD-10 used Z71.0 for the diagnosis. Can't promise you it will be paid.

 

[CodingKing]

Medicare requires patient present. for other types you want to check directly with payer for their policy

 

[mschnepper]

Patient not present

That has always been my mindset. However, somebody recently pointed out section 70.1 of the Medicare National Coverage Determination Manual saying that in some instances it is payable.
I posted info on section 70.1 earlier today in another thread: https://www.aapc.com/memberarea/forums/43276-family-meeting-cpt-code.html#post393549

This kind of muddies the water and now I am not sure it is a "hard line" depending on the nature of the counseling of course.

Regards,

Mark