First - who is the payer? If it is a government payer the patient MUST be present.
Okay, the patient is terminally ill. Did the meeting (it is NOT a consultation) with the spouse occur on the hospital floor/unit? If so, that is considered "face-to-face" with patient. Use the counseling/coordination of care rules to determine the level of subsequent hospital visit.
If the visit occurred in the physician's office, you can code it ONLY if the patient is NOT covered by Medicare or Medicaid, and the documentation must state the reason why the patient is unable to participate in the discussion ("terminally ill and in hospice care" would cover it).
I know many physicians who do not charge anything for these types of visits with family. They consider it a part of the complete medical care of their patient.
Hope that helps.
F Tessa Bartels, CPC, CEMC
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