Psychiatry Coding & Reimbursement Alert

Question: We had a son and daughter-in-law in our office seeking advice on his father. The father was not in attendance. How do we bill for this? Do we bill the fathers insurance with the diagnosis of V61.3 and V65.19, or do we bill the son’s insurance with the same diagnosis?

Utah Subscriber

Answer: The most straightforward way to bill for this encounter is to treat it as a service to the son with a diagnosis code of V61.3 (Problems with aged parents or in-laws)and either V65.19 (Other person consulting on behalf of another person) or a code from the range V61.41-V61.49 (Otherhealth problems within the family).

The latter range covers concerns about health problems within a family. If the problem for which the son is consulting does not concern alcohol or substance abuse, then you have to use V61.49. These diagnoses would not apply to the father, since he is not the one with problems with aged parents/in-laws (V61.3) and is not the one consulting on behalf of another person (V65.19).

Since the son was seeking advice for his father, you will have to use one of the above mentioned codes, and you will have to bill out to the son’s insurance and not the father’s insurance. This will be more appropriate as the diagnosis code that you will be using is relevant to the son and not to the father directly.

Alternative: When you begin using ICD-10 codes, you will have to use Z63.79 (Other stressful life events affecting family and household) as the alternate code to V61.3. You can substitute V65.19 with Z71.0 (Person encountering health services to consult on behalf of another person) when using ICD-10. The code range, V61.4x crosswalks to Z63.7- (Other stressful life events affecting family and household) in ICD-10.