Wiki Billing Coordinator

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3
Location
Piscataway, NJ
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HI,

I need some clarification as this has been going back and forth in our office and perhaps I am reading this wrong. I have two questions. The first one is regarding genetic counseling CPT 96040. In the CPT book it reads face to face counseling yet it also states counseling of patient/family. I have always believed that the patient needs to be present in these counseling sesions. Yet when I look up the meaning of the / (slash) it can mean or. My question is does the patient need to be present to bill for the patient. We have parents that are coming in for a genetic counseling session that has to do with their baby can we bill for the child and not the parents it the child is not present?

My Second question can our physician bill an outpatient conuslt without the patient being present?

I have another question. Can our physican bill an outpatient established code without the patient being present. In both cases the parents will be present. What CPT codes should I use.

I'm so sorry I have one more question. Our genetic counselors go to the Inpatient floor to see patients on some ocasions and als counsel. Can they bill an outpatient 96040 while the patient is inpatient. I have always thought he answer to be no since the patient is an inpatient and they would not be able to charge to our department as it would be impossible to charge out patient when patient is inhouse. Please let me know what you think.

Thanks,

AS in Genetics
 
Help need answer to billing 96040 and E/M codes

Hi,

Can someone please help answer these questions. I'm not sure if we can bill or not.

Thanks,

Amida
 
Our practice does not bill for anything that is not face-to-face with the patient, with the exception of telephone consultations.
I interpret the Code 96040 is reported for each 30-minute increment of face-to-face time to mean that you MUST have the patient present.
We have the parents bring the children, the exam is then done and then the patient can go to the waiting room to play games or watch television while the parents talk.
 
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