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can we bill E/M code without patient attendence?

  1. #1
    Question can we bill E/M code without patient attendence?
    Exam Training Packages
    Hello all,

    I have received follow-up office visit document, patient not able to getup so father was came to doctor office to get the medication from doctor. Please advice can we bill office visit without patient present?


    Banu-CPC.

  2. #2
    Location
    Columbia, MO
    Posts
    12,557
    Default
    You would bill an office visit for a father to come and pick up medication? I am saying no this cannot be done.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Seattle First Hill
    Posts
    126
    Default
    Was that the only reason the father came in? To pick up the patient's medication?

  4. #4
    Angry Are you kidding?
    I can't believe this Dr. is so desperate for a dollar that this would even be considered a chargable issue.
    If this were my physician, I would quickly look for another one that had some common sense.

  5. #5
    Default Hi All,
    Thanks for your advice,

    Initially we did not charge for this account, but our clien get back with us stating CPT description says patient and/or family so we would need to bill for this service. Kindly advice what is the correct meaning for below description.

    "counseling and/or coordination of care with other providers or agencies are provided consistent with the nature of the problem and the patient and/or family needs".

    Banu.CPC

  6. Default
    What services are actually being provided for this patient? If its just picking up medication, that isn't a billable service according to all of my manuals. There must be other information you have that would help us understand the situation and why this would be something someone would thing a charge applies to.

  7. #7
    Location
    Seattle First Hill
    Posts
    126
    Default
    An example of the phrase that you are referring to would be a patient that needs to go to a skilled nursing facility after surgery. The physician would coordinate care with that facility for the patient.

    A father simply picking up medication for the patient, does not, in my opinion, fall under this.

  8. #8
    Default
    Thank you all


    In E&M subsq visit(99231-99233), provider done debridement of wound separately. and stating I spent totaly time 1hr 10 min face to face time including cleaning and dressing of wound.

    99233-25
    99356-25
    11042

    kindly see the above coding: My manager wants to code 99356 for this scenario.

    But my understanding is, if we are coding debridement(11042) separately, so we should not use 99356, because dr states total time includes the surgery.

    please clarify me

  9. #9
    Location
    Milwaukee WI
    Posts
    4,466
    Default Prolonged Service
    I am assuming this is a NEW scenario ... not the one where the dad picked up the medication for son. (In general, it is best to start a new thread with a new scenario.)

    You are correct. You can not include time spent for separately coded procedures in the prolonged service time.

    Code only basic E/M service and procedure.

    F Tessa Bartels, CPC, CEMC
    Last edited by FTessaBartels; 11-17-2009 at 01:44 PM.

  10. #10
    Default
    Review the E/M section guidelines - these require face-to-face time with the patient.

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