# Can we bill for counselling a family about a medical decision ?



## kviolet (Mar 9, 2009)

my doctors  often have to spend protracted periods of time counselling a family about a medical decision or arranging their transfer to an outside hospital, care facility.  
Can we bill for that?


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## kevbshields (Mar 9, 2009)

Sure you can.  Ensure that the providers clearly document their time and how it is spent.  I'd recommend use of the Prolonged Service codes in the E/M section (like 99358, etc).

Good luck!


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## dbarker (Mar 9, 2009)

Okay, So I have a patient who is at the local nursing home.  He was recently diagnosed with Renal Failure.  The daughter (who also works at the nursing home) came to the clinic and spent about 15 minutes with the physician because she wanted to ask questions in regard to what should the family expect, etc, etc, etc.  I was always told (coding class) that unless the patient comes in with the family, it's pretty much a "freebie".  ??????  I have never charged for it....but our physician argues with me every time.  The descriptions for the prolonged codes I think are gray.  Anyone else have ideas on this scenario?


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## ARCPC9491 (Mar 10, 2009)

The E/M codes say ... "patient and/or family" ...


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