Wiki Parental Counseling

[thelton]

This is posted in the Pediatric forum, but I wanted to post here as well for as many opinions as possible. The mother of an established patient was seen by one of our pediatricians to discuss behavior concerns, etc. about her child. The child was not present. Is this a billable service under the child's account/insurance? If so, can anyone tell me where to find guidelines that state this is billable? I appreciate any help you can give.

 

[OCD_coder]

It is really important to know what insurance the patient is under. For CMS, Anthem BCBS, UnitedHealthcare, absolutely not. There must be some form of face to face encounter time on the DOS to bill any E&M services.

You will have to contact the payor and see what their requirements are.

 

[thelton]

Thanks Michelle!!!

 

[pineapplelvr]

Our practice is that if the patient isn't present we can't bill it to the patient...we would bill this to the mother (and most likely her insurance wouldn't cover it--we would use a counseling dx code)