End-of-Life

Our practice sees many elderly patients who have questions regarding end-of-life. This can require a lot of counciling time by the provider. Often POLST forms, Advanced Directives, etc. need to be filled out and occasionally the patient is referred to Hospice. How can we bill for these sensitive and lengthy visits?

Send the bill to:

Sarah Palin- almost-lame duck ex-Governor
c/o Fringe Right Republican Headquarters
Glacier in the middle of Alaska with secessionist husband
USA that is visible from Russia

There is no code for counseling on end of life issues; it can be included in your general counseling and coordination of care time. And Editor can be more specific but I believe it is considered "high intensity" medical decision making.

(excuse my political commentary- hope I did not offend anyone)

coding for the elderly

No, I totally understand where you're coming from - so you didn't offend me.

I just hope that we see some changes in coding for the elderly - especially as our baby-boomers enter the later stages of health care. Seems like those that write the codes have been focusing on the ever-expanding procedure codes while primary care gets left with "best fit" - like reimbursement for primary care and family practice isn't bad enough!

end of life

Medicare would like this address in the welcome to medicare visit. If it is during the time of their end stage disease this would count towards time of the E/M if all is noted in the chart correctly. Go Sarah!

re: end of life

Actually, there is an end of life code that was created 2005/2006.

S0257 - Counseling and discussion regarding advance directives or end of life care planning and decisions, with patient and/or surrogate (list separately in addition to code for appropriate evaluation and management service)