Wiki Help! Office visit with family; pt not present

[jhendrix08]

Hi everyone...

We had a patient's family member come to the office today for a scheduled appt...without the patient. Family stated that the patient has become more combative and it's difficult to get him in the office. Our provider decided to go ahead and discuss the concerns with the family. The patient has original Medicare. My understanding is that Medicare does not allow you to bill if the patient is not present but I'm having a hard time finding good info that I can show our provider. Am I right or wrong? Can someone provide a link with the info?

Much appreciated!!

 

[shanamarie]

Hi everyone...

We had a patient's family member come to the office today for a scheduled appt...without the patient. Family stated that the patient has become more combative and it's difficult to get him in the office. Our provider decided to go ahead and discuss the concerns with the family. The patient has original Medicare. My understanding is that Medicare does not allow you to bill if the patient is not present but I'm having a hard time finding good info that I can show our provider. Am I right or wrong? Can someone provide a link with the info?

Much appreciated!!

What about using the prolonged non face to face codes? 99358-99359

 

[jhendrix08]

Thanks for your suggestion...I really appreciate it. The provider only spent about 15min with the family member so it looks like the criteria won't be met for billing the prolonged non face to face code.