Wiki Help!! family conference without pt present

[cynthiaj54]

One of our offices is having a family come in to discuss the pt(who is in the hospital). The doctor will probably spend a good amount of time on this. Should or can they bill for this? It is commericial insurance.
Thanks

 

[Walker22]

Yes, that is a billable charge. Make sure your physician documents how much time was spent, who was present, and what was discussed (in detail).

Here... read this... have fun!

https://www.aapc.com/memberarea/forums/showthread.php?t=27538

 

[FTessaBartels]

Purpose of the visit?

If the purpose of the visit is to meet with the designated medical-decision makers when the patient is unable to participate in decisions related to treatment, then yes, you can bill this visit. You will use the time-based guidelines for counseling/coordination of care to choose the appropriate level of service.

If the purpose of the visit is to "counsel" the family on their reactions, goals, etc. and is NOT for medical decision making on the treatment of the patient it is NOT billable. You should have some policy in place regarding charging for such meetings, clearly outlining the family's financial responsibility BEFORE they come to the conference.

NOTE - if the patient is hospitalized and you are meeting family in the office you'll probably get a denial because the POS for this DOS won't match the patient's current status. I'd suggest you arrange to get a conference room in the hospital unit for the meeting.

Hope that helps.

F Tessa Bartels, CPC, CEMC