# End of life issues



## heathergirl (Apr 15, 2008)

I need some help with a dx code.  I had a patient come in to discuss end of life issues with my Dr.   He is not currently ill with any terminal illness, but she spent alot of time discussing choices and filling out paperwork.  I have searched and searched.  I need help!  Thanks


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## ndhight (Apr 16, 2008)

Maybe look at 99080.
Nichole


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## Teresa Collins (Apr 17, 2008)

Do you think V65.49 (other specified counseling) would work?

Just a thought!

Teresa Collins, CPC


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## FTessaBartels (Apr 22, 2008)

*Counselling & Coordination of Care*

CPT states that when more than 50% of the time spent in face-to-face visit is for counselling & coordination of care, then TIME SPENT determines the level of the E&M visit.  (see page 8 of the 2008 CPT Professional Edition, paragraph 3.)

The physician must document:
  TOTAL time spent face-to-face
   Amount of time spent in counselling/coordination of care
   General description of reason for counselling.

As an example:
I spent 40 minutes with Patient today, 100% of time in counselling & coordination of care, discussing end-of-life issues and assisting patient with preparation of living will, DNR documents. 

If this was a new patient, this above "note" would be coded as 99203.
If it was an established patient, it would be coded as 99205.

F Tessa Bartels, CPC EMA


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## linstedtt (May 12, 2008)

What about V65.4- Other persons seeking consultation without complaint or sickness, other counseling, not elsewhere classified??  You need a fifth digit as well.  My guess is that you would need to submit with office notes to actually get payment for this.


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