Pediatric Coding Alert

Question: One of our patient's families will potentially be adopting a child and have asked our physician to review the biological family's medical records. Assuming we get the biological family's consent and everything goes through the legal process, what can we charge for his time spent reviewing the chart and discussing it with the potential parents? It will be a selfpay situation.

Vermont Subscriber

Answer: The situation as described is not a separately codeable service. Many physicians consider these types of services to be "practice builders" and don't charge for their time. If you decide to bill for it, the parents must pay out of pocket.

Exception: If you can relate the physician's work to a later face-to-face E/M visit and have adequate documentation, you might be able to code for the medical records research. Include the physician's time with your calculations for non-face-to-face physician services and choose the appropriate code:

• 99441 -- Telephone evaluation and management service provided by a physician to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion

• 99442 -- ... 11-20 minutes of medical discussion

• 99443 -- ... 21-30 minutes of medical discussion.