Ob-Gyn Coding Alert

Question: A Medicare patient's daughter scheduled an appointment with the family physician to discuss her mother's care. The patient was not present during the visit. The physician's notes don't mention the amount of time spent discussing the patient with the daughter, or exactly what they discussed. Is there a code we can report to capture this encounter?Wisconsin SubscriberAnswer: Medicare typically only reimburses care when the physician documents face-to-face time with the patient. The limited exceptions under which Medicare covers consultations with a beneficiary's family are described in section 70.1 of chapter 1 of the Medicare National Coverage Determinations Manual, which you may find online at http://www.cms.gov/manuals/downloads/ncd103c1_Part1.pdf It is not apparent that your situation fits these limited exceptions, so in all likelihood, your physician provided a service that is not payable under Medicare.You do have an option to consider for next time, however: View the encounter as a service to [...]