hthompson
Guru
Hi all, I'm trying to find out the proper method, if any, to bill for a counseling visit re: Advanced Directives forms that were recently sent to all our patients over 18.
I personally think that it's billable if the provider is spending 10-30 minutes counseling on the risks/benefits of life support treatments and which ones the patient would or would not prefer to undergo, end of life care, donating organs and autopsies, that it falls into the counseling definition of the AMA:
AMA Comment: The CPT nomenclature defines counseling, as it relates to E/M coding, as a discussion with the patient and/or family or other caregiver concerning one or more of the following areas: diagnostic results, impressions, and/or recommended diagnostic studies; prognosis; risks and benefits of management (treatment) options; instructions for management (treatment) and/or follow-up; importance of compliance with chosen management (treatment) options; risk factor reduction; and patient and family education.
I'm being told "I don't see why this would be considered medically necessary and qualify for counseling or time."
Can I get some feedback? I want to understand why this is non-billable, if that is the case.
FYI - I do understand that when a patient brings in a completed form during their visit, that it is not billable, as it is already signed and just ready to be filed in the patient's chart.
Another thing to think about... What if the patient is here for hypertension and it would normally be a 10 minute visit and these questions come up re: Advanced Directives, so the visit is now a 30 minute visit. Is that time now allowed to be included in the E/M for counseling?
I personally think that it's billable if the provider is spending 10-30 minutes counseling on the risks/benefits of life support treatments and which ones the patient would or would not prefer to undergo, end of life care, donating organs and autopsies, that it falls into the counseling definition of the AMA:
AMA Comment: The CPT nomenclature defines counseling, as it relates to E/M coding, as a discussion with the patient and/or family or other caregiver concerning one or more of the following areas: diagnostic results, impressions, and/or recommended diagnostic studies; prognosis; risks and benefits of management (treatment) options; instructions for management (treatment) and/or follow-up; importance of compliance with chosen management (treatment) options; risk factor reduction; and patient and family education.
I'm being told "I don't see why this would be considered medically necessary and qualify for counseling or time."
Can I get some feedback? I want to understand why this is non-billable, if that is the case.
FYI - I do understand that when a patient brings in a completed form during their visit, that it is not billable, as it is already signed and just ready to be filed in the patient's chart.
Another thing to think about... What if the patient is here for hypertension and it would normally be a 10 minute visit and these questions come up re: Advanced Directives, so the visit is now a 30 minute visit. Is that time now allowed to be included in the E/M for counseling?