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Follow up visit for parent of patient only?

  1. #1
    Location
    Woodbridge, Virginia
    Posts
    72
    Default Follow up visit for parent of patient only?
    Medical Coding Books
    Can we charge a follow up visit for a child if the parent is coming in only to discuss test results with the doctor? If so, would this charge be coded on time only?

  2. #2
    Location
    Central Pittsburgh
    Posts
    164
    Default
    All E/M services require face-to-face contact with the patient. In the pediatric world, some of these rules seem odd (i.e. patient is 6 months old-the child being there doesn't really affect the decision-making). But, without the face-to-face, you wouldn't be able to bill an E/M.

  3. #3
    Location
    Woodbridge, Virginia
    Posts
    72
    Default
    If that's the case, why do they mention "physician typically spends 10 mins face-to-face with the patient and/OR FAMILY? (for CPT 99212)

  4. Default
    In the E/M guidlines section of the CPT it has a little blurb about time and states "The inclusion of time in the definitions of levels of E/M services has been implicit in prior editions of the CPT codebook. The inclusion of time as an explicit factor beginning in CPT 1992 is done to assist physicians in selecting the most approriate level of E/M services......" Code selection can not be determined based solely on time. Unfortunately the prior response was correct.

    Wendi Healy CPC

  5. #5
    Location
    Alexandria Minnesota Chapter
    Posts
    50
    Default
    Quote Originally Posted by GIBBERS View Post
    If that's the case, why do they mention "physician typically spends 10 mins face-to-face with the patient and/OR FAMILY? (for CPT 99212)
    If anyone has an answer to this, I'd like to hear it too.

  6. #6
    Location
    Woodbridge, Virginia
    Posts
    72
    Default
    If we can not use an E/M code when just the parents come in to discuss their child's upcoming surgery, does anyone know of a CPT code that we can use, even if it is only to send the bill to the parents. The only one that I could come up with is CPT 99499 (unlisted evaluation and management)

    Thanks for everyone's help!

  7. #7
    Location
    Milwaukee WI
    Posts
    4,466
    Default Global
    Gibbers asks: If we can not use an E/M code when just the parents come in to discuss their child's upcoming surgery, does anyone know of a CPT code that we can use, even if it is only to send the bill to the parents. (emphasis added by FTB)

    If the decision for surgery has already been made previously then this visit is probably considered part of the global period - even if it is more than 24 hours before the scheduled date of surgery.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  8. #8
    Location
    Woodbridge, Virginia
    Posts
    72
    Unhappy
    The decision for surgery was made on the same day as the parents only/surgeon conference.

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