Results 1 to 4 of 4

minor patient, not present

  1. Question minor patient, not present
    Exam Training Packages
    I have a scenario that is new to me.

    We have been referred a surgical consult for a minor patient. The parent's want to come in and consult with the doctor - without the patient attending.

    Any suggestions on how this would be billed?
    ~Ursula, CPC~

  2. #2
    Milwaukee WI
    Default Is there a medical reason for the patient being absent
    Is there a medical reason the patient cannot be present? Is the patient in a coma? Have severe mental disabilities? Currently quarantined for infection control? Or perhaps the patient is VERY young (a neonate, or infant younger than 1 year)?

    If you have a legitimate medical reason why the minor cannot be present (not just that they don't want to take him out of school today), then you can code based on time spent for counseling/coordination of care. Your documentation MUST include ALL of the following elements:
    1) Total time spent with parents
    2) Amount of time spent in counseling/coordination of care (must be MORE than 50% of Total time)
    3) Summary of discussion
    4) REASON why patient is unable to participate in the medical decision making and the visit therefore is with parents only.

    If the parents just don't want the child present then they will be responsible for the consultation charge.

    Be aware that if the patient is covered by Medicaid or Medicare (even as secondary) the patient MUST be physically present for this to be a billable service.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. Default
    It helps a LOT. Thank you!!
    ~Ursula, CPC~

  4. Default
    In follow-up, it appears that there is absolutely no medical reason for the absence of the patient. The parents chose to schedule a time to come in and discuss the possible options with the doctor themselves, prior to scheduling the pre-op/surgery visits.

    Self-pay, it is!!

    Thanks again for your help!!
    ~Ursula, CPC~

Similar Threads

  1. New patient minor procedure with E/M
    By tovygoldstein in forum E/M
    Replies: 3
    Last Post: 09-15-2014, 08:38 AM
  2. Minor patient bill guarantor??
    By mputerbaugh in forum Compliance General Discussion
    Replies: 0
    Last Post: 08-17-2012, 12:55 PM
  3. Patient Not Present
    By uksjmartin in forum E/M
    Replies: 2
    Last Post: 09-24-2009, 02:17 PM

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?


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.