Wiki Family conference/counseling

[bill2doc]

We have a patient that cannot communicate. His nephew has complete all of the needed doc's to discuss care. Is there a code that I can bill to California Medi-cal to be reimbursed for the 45min conference? The pt was not present, bedridden.

Thanks!

 

[kbreynolds]

Family counseling/Conference

I am not sure about California but in North Carolina insurances generally don't cover family conference pt not present. We have internal codes one for less than 15 min and one over 15 min and the family is made aware when making the appointment that insurance will not pay and they will be responsible for paying the charge at the time of service.

 

[sparkles1077]

Actually, you can bill an evaluation and management code when the family is present. See CPT description (99213 as an example):

Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.

 

[Shawna Paul]

billing for family meetings with no patient present

I have seen this topic discussed several times over the years. I was just doing some research on it and found this article from the Physicians Practice website and thought I would share it:


http://www.physicianspractice.com/pearls/billing-family-meetings


Hope everyone finds this helpful. The Medicare part answered my specific question.

Good luck,
Shawna