Results 1 to 6 of 6

E/M code when Doc meets with Family ??

  1. #1
    Location
    Salt Lake North
    Posts
    620
    Cool E/M code when Doc meets with Family ??
    Medical Coding Books
    Here's the situation. Very elderly patient. Their relatives comes to the clinic to discuss and get advice about the patient since the patient can no longer take care of themselves and participate in their own management of care. Can this be billed? What code? Thanks for your suggestions.

  2. Default
    You can bill it as a regular established office visit E/M code as the CPT book states "counseling or coordination of care with other providers or agencies are provided consistent with the nature of the problem(s) and the patient's and or the family's needs. Physican's typically spend ____ minutes face-to-face with the patient and/or family." Since the patient may or may not be there, this would have to strictly be a time based coding with careful documentation of the time started, detailed documentation about what was discussed, and the time ending. Diagnosis of the patient's condition will also need to be documented. Now just because you bill it, depending on the carrier, does not necessarily mean you'll get paid.
    Hope this helps!

  3. #3
    Location
    Milwaukee WI
    Posts
    4,466
    Default WHY can't patient be present and participate
    I agree with bclegg, but just want to add ...

    It's also important to document WHY the patient him/herself is unable to pariticpate in the medical decision making. Medically valid reasons include: dementia, coma, intubated, noncommunicative, etc (you get the idea).

    The adult children of an elderly patient coming in to discuss "Mom/Dad's" case is by itself not sufficient documentation to make this a billable service (doesn't mean you can't charge the adult children a fee, just means you can't bill to Medicare).

    Hope that helps,

    F Tessa Bartels, CPC, CEMC

  4. #4
    Default
    Also to consider is that the discussion has to focus on how to care for the patient. Discussion of coping mechanisms for the family (for example) is not considered part of the billable service.

  5. #5
    Location
    High Point, NC
    Posts
    84
    Default
    I have a question that is specifically related to this issue. Could these type visits be billable using CPT codes 99339 & 99340? I'm still a little fuzzy on when to use these codes vs the established patient codes for these type visits. I had a coworker state to use 90846 for this type of family 'counseling', but this is a psychotherapy code and these visits are not for psychotherapy counseling.

    Thanks for the help!
    Cindy Gallimore, CPC, CENTC

  6. #6
    Location
    Milwaukee WI
    Posts
    4,466
    Default 99339-99340 not
    No, a visit with the patient's family to discuss the medical management of the patient is NOT reported with 99339 or 99340.

    Use the established patient office visit code based on time spent in counseling/coordination of care.

    F Tessa Bartels, CPC, CEMC

Similar Threads

  1. How to code when doc is on vacation
    By Orthocoderpgu in forum E/M
    Replies: 2
    Last Post: 07-31-2012, 06:02 PM
  2. can coder select E/M code for doc?
    By recy in forum E/M
    Replies: 2
    Last Post: 04-07-2011, 01:07 PM
  3. Training a Doc on E&M Doc.
    By Viper66 in forum E/M
    Replies: 1
    Last Post: 07-02-2010, 12:39 PM
  4. ER Doc and Ortho Doc Fx Care
    By kristinab in forum Orthopaedics
    Replies: 1
    Last Post: 06-25-2010, 04:05 PM
  5. 1st doc can't complete DRE,2nd doc bills how?
    By uhlerclarem in forum E/M
    Replies: 1
    Last Post: 08-13-2009, 08:22 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.