AAPC - Back to school
Page 2 of 2 FirstFirst 12
Results 11 to 12 of 12

Thread: Doctor/Parent encounter without child present ?

  1. #11
    Join Date
    Apr 2007
    Duluth, Minnesota


    AAPC: Back to School
    Quote Originally Posted by Lisa Curtis View Post
    I disagree. E/M codes are meant for the evaluation and management of a patient - meaning the patient must be present for the evaluation. Counseling and coordination of care can include discussion with parents or guardians regarding management, but if the patient is not present you are missing the evaluation piece. Time can be considered the controlling factor to qualify for a level of service, but the patient still must be present for an E/M to be reported. These codes are meant for patient encounters, not family encounters.

    Anyone else in the E/M community want to weigh in on this?

    Lisa Curtis, CPC, E/M
    Hey Lisa - I have this very same conversation going in another forum - I agree with you, I don't see how you can charge an E/M under the patients name if the patient isn't there...I know at my other facility we never could/never did. We would code and E/M visit under the person who was there, we used a V code (V65.1 or whatever), highly unlikely it was paid, it usually ended up to be "self-pay" visit. (but I'm not a biller so I didn't follow payment) I don't think the notation under the E/M's that state "and/or family" means "so if PATIENT NOT THERE and family is, you can bill patient". I don't know, I got scolded in the other forum for giving my opinion
    Donna, CPC, CPC-H

  2. #12
    Join Date
    Apr 2007
    Greeley, Colorado


    I guess since CPT doesn't specifically state in the E/M guidelines that the patient "must be present", it comes down to the individual coder interpretation. My interpretation is that the patient must be present for an E/M to be reported. My interpretation therefore is my opinion. I would not advise my providers to code an E/M if the patient is not present.

Page 2 of 2 FirstFirst 12

Similar Threads

  1. Visit with Parent- Patient not Present
    By BrendaC1957 in forum Family Practice
    Replies: 2
    Last Post: 08-06-2013, 12:15 PM
  2. child and parent(s) therapy
    By HavaTwo in forum Behavioral Health
    Replies: 8
    Last Post: 08-03-2009, 07:02 AM
  3. Counseling Parent w/out pt present
    By lapcpc in forum E/M
    Replies: 5
    Last Post: 05-18-2009, 09:09 AM
  4. Parent Consulting on behalf of child??
    By puggles in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 02-27-2009, 01:12 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.