# Palliative care



## MINDYRUDYAN (Mar 23, 2009)

This is new to me, anybody out there have  billed for this(consults). I have questions about the documention of needed for this type of care


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## TTcpc (Mar 23, 2009)

We've been doing outpatient palliative care in the patient's home setting now for about 7 years.  If you want to send me your questions, I'll do my best to answer them.


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## MINDYRUDYAN (Mar 23, 2009)

My problem  is the dr is a family practice dr. He was asked in consult by another dr (internal) for his advice on clarifaction of goals of care(per consult) what he gave me to bill his medical dx's
malnutrition,ca,hypertension,but the dictation clearly says the reason for consult was goals of care. He feels per the training he got from the assoication of palliative care that is what he is supposed to do. I feel that is incorrect.


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## TTcpc (Mar 24, 2009)

Your feeling is right.  When we are asked for a consult for goals of care, our MD/NP codes for visit based on time with documentation of the discussion and then use the diagnosis for which they are considered pallaitive (or what condition they are discussing the goals of care for ie. cancer, terminal heart/lung disease, etc.).  Our staff however is employed by our hospice, but we have not had any problem with that.  The only time that they bill for any other E/M or dx is if during the visit the patient asks them about an issue, but then they also report that issue to the referring MD.  
I hope this helps some


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