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Genetic Counseling Help!

  1. Unhappy Genetic Counseling Help!
    Medical Coding Books
    I am just starting a new position in a OB/GYN, Maternal Fetal office. I have been asked about genetic counseling, which is done frequently by one of the physicians. I know the licensed office visit CPT code is 96040 but I am having difficulty with the physician herself. I do not feel comfortable using a 99213 for example if all she does is counsel but even though the 99401 series of codes seems to fit, I am a little weary about these too. Please help! Thanks

  2. #2
    Default Genetic Counseling
    Hi there! I am familiar with E/M coding/auditing for Genetic Counseling. Maybe you might suggest to the physician to document time and use the "time component". Per 2008 CPT, pg. 8 - "When counseling/coordinating care dominates more than 50% of the total visit (face-to-face)..time may be considered the key to seleting the level of service..."

    The documentation must indicate:
    1. the total time
    2. the % of time spent counseling
    3. what was counseled &/or coordinated

    For example:
    "I spent a total of 80 minutes with this patient and more than 50% was spent on counseling the patient on her paternal lineage" OR

    "An extended visit of 75 minutes was conducted for a discussion of the patient's test results, screening and risk-reduction recommendations which all of the time was devoted to counseling"

    I hope this helps!!

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