See the below thread that covers billing when patient not present:
What you consider is that patient is not present (i.e., no physical exam, no review of systems (hands on), little to no medical decision making, etc.) so is 50% or more of the time spent on counseling? Yes, 50% or more - in fact 100% of time is spent on counseling and you choose the appropriate established E/M OV code based on time spent. I learned this from an expert. An expert in my mind as he has 20+ years coding experience, trains Medicare auditors on what to look for in an audit, consults with Medicare, has a published book specifically on what E/M code to choose, travelled the country teaching CPC bootcamp courses (I was one of the students) and a boatload of letters behind his name. So, I will defer to his word on this over those on this site that can't comprehend billing an OV for a patient that is not in the room (there are several on here that refuse to do it).
I used to interpret contracts for a living in the telecomm industry and a lot of what I did was read between the lines - this is one of those cases in coding as there is no E/M that is defined as "patient not present" so we have to read between the lines of "50% or more time spent on counseling".
Hope this helps,
Hunter Smith, CPC
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