Results 1 to 4 of 4

Well Newborn + Addt'l Problem for mother

  1. #1
    Location
    Charm City - Baltimore
    Posts
    103
    Default Well Newborn + Addt'l Problem for mother
    Exam Training Packages
    Hello -

    I have a 5 day old newborn coming in for a well visit. Peds performs the required exam and during the visit, mother bursts into tears. Physician counsels and talks to mom about "feeling down and overwhelmed."

    Physician wants to code an E/M for this counseling where postpartum group info was given along with discussing famiy support, counseling, anti-depressents, etc.

    Two-fold question:

    1. Is is appropriate for Peds to bill for visit w/Mom?
    2. Depression has not been formally diagnosed. Would V65.49 (other counseling, other specified) be appropriate if billable?

    Thanks.
    Crystal, CPC, CCS-P

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default Bill Mom's care under HER name
    If the physician provided service to the patient (in this case Mom), then yes, it is appropriate to code and bill that service per documentation. Of course, the service would be billed to Mom's insurance with Mom as the patient.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Location
    Tacoma, WA
    Posts
    1,087
    Default
    Quote Originally Posted by CrysLednum View Post
    Hello -

    I have a 5 day old newborn coming in for a well visit. Peds performs the required exam and during the visit, mother bursts into tears. Physician counsels and talks to mom about "feeling down and overwhelmed."

    Physician wants to code an E/M for this counseling where postpartum group info was given along with discussing famiy support, counseling, anti-depressents, etc.

    Two-fold question:

    1. Is is appropriate for Peds to bill for visit w/Mom?
    2. Depression has not been formally diagnosed. Would V65.49 (other counseling, other specified) be appropriate if billable?

    Thanks.
    I think you might run into an issue billing for "counseling" services for Mom when your provider's expertise is Pediatrics. Part of the services provided to newborns involves checking on the status of the family as a whole. Suggesting other services for mom to check into due to possible postpartum depression would not constitute an additional service. Do you bill additional services when talking with the mom about breastfeeding?
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

  4. #4
    Location
    Charm City - Baltimore
    Posts
    103
    Default
    Good point Arlene! I had not thought of it in that respect.

    thank you!
    Crystal, CPC, CCS-P

Similar Threads

  1. Newborn billing under mother or child?
    By CMPM12 in forum Billing/Reimbursement
    Replies: 2
    Last Post: 12-28-2015, 06:55 AM
  2. Newborn well visit with problem visit
    By bkudsk in forum Pediatrics
    Replies: 2
    Last Post: 12-24-2015, 10:36 AM
  3. Newborn of Gestational Diabetic Mother
    By clbarry8033 in forum Pediatrics
    Replies: 0
    Last Post: 10-05-2015, 10:58 AM
  4. Newborn under mother denial
    By MarnieMBSI in forum OB/GYN
    Replies: 1
    Last Post: 10-19-2011, 05:06 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?

Login

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.