Medicare paying
lschoen,
Yes, medicare pays when patient not present. Actually, a Medicare patient may be the most likely scenario - patient in nursing home, homebound, etc. and family members caring for the patient need to discuss with provider plan of care, prognosis, etc. Medicare pays fraudulent claims everyday I'm sure, they don't know if the patient is in the building/seen or not. It is our job to ensure we don't submit fraudulent claims and bill within the guidelines and the guidelines do allow you to bill an E/M OV for patient not present. As stated previously in this feed, there should be a valid reason patient is not there and that should be clearly documented in the note by the provider.
Hope this helps.
Hunter Smith, CPC