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Thread: Genetic counseling - I have a genetic counselor

  1. #1

    Default Genetic counseling - I have a genetic counselor

    AAPC: Back to School
    I have a genetic counselor who is employed by a genetics lab that works in a high risk ob office. She works directly under the Director of the Lab and he signs off on all reports. How would I bill for the genetics counseling session? Sessions last between1 to 1.5 hours.
    My options are the 99241-99245 series- But does a pedigree take the place of an examination? And does a counselor replace a physician? There is a request for a consult and there is the pedigree that is constructed and there is a resulting report from the Lab Director who is a PHD in Genetics.
    The 99401-99404is another counseling code that is being considered.
    Thanks for the help

  2. #2
    Join Date
    Apr 2007


    Do your carriers credential genetic counselors?

    If not, you can't bill under them. The only way to get reimbursement is if they are employed by the facility and their cost is built into the facility fee.

    As far as I know E/M would not apply to genetic counselors, they should be billed using 96040 when they are credentialed billing providers.

    Laura, CPC, CEMC

  3. #3
    Join Date
    Apr 2007


    I was researching this 96040 code and came across your posting back in Aug. I have a question regarding phone conversations that the genetic counselor will have with patient following the service. Is this a billable charge or is it included in the intial counseling.

    Appreciate any help you can give...
    Thank you,
    Kristen Richard, CPC

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