Family counseling...

Hello all-

I work for a Hematology/Oncology office and we have a patient that was in the hospital- so she couldn't come to her scheduled appt, but her family showed up in her place.

Dr's first sentence of the letter states.... Patient X is hospitalized and her family comes in her place to discuss her condition and I spent 45 mintues face-to-face with them.

I can not bill for this service can I? A- the patient is in the hospital- so it isn't face-to-face. B- Medicare will only pay if the patient is there

Please let me know if there is any code I can bill

Thanks for you help!

counseling family

You cannot bill the patient. If you do bill,it will be based on payer policy, it is to family member and they should be told up front. This communication is included in patient care for medicare. Billing may prove a PR issue.

child has behavioral issue mom comes in without child to discuss

How would you bill for a parent coming to the pediatrician to discuss their child's behavior issueswithout the child present

Thanks,

Family counseling

The CPT book defines services as "with patient and/or family" for the E/M codes. So, from a CPT perspective, yes. (We know Medicare doesn't allow it.)

The issue is the diagnosis. Correct coding would have you use a V code, V65.19 "Other person consulting on behalf of another person." If you put that as the first diagnosis, I am afraid it will deny.

Remember, too that the patient will get the EOB that shows that they visited on a day they didn't have an appointment.