Wiki Non face-to-face office visit

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pamelat

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What is the appropriate E/M to bill when parents of an autistic child (the patient) meets with the physician without the patient being present?

The patient is established with the physician, but the parents have concerns and need to discuss the coordination of care for the child without the child being present.
 
pamelat said:
What is the appropriate E/M to bill when parents of an autistic child (the patient) meets with the physician without the patient being present?

The patient is established with the physician, but the parents have concerns and need to discuss the coordination of care for the child without the child being present.
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The CPT descriptions of 99211-99215 include the notation "time with patient and/or family". However, you will need to check with the payer. Medicare will not pay for any visit that the patient is not physically present for, but some others will. If they will, get it in writing. Our clinic policy is to inform the family before the appt whether or not the payer will cover it, and if not, to collect in full from the family prior to the appt.

HTH!
 
E&M Without Patient Present

Pam:
I would think that your best choice may be the unlisted E&M code, accompanied by the V65.1 diagnosis code. You may also be prepared to have the parents sign the ABN, in anticipation of non-payment by the carrier. I am told that many physicians perform such services as a zero charge, "compassionate care" sort of visit. Seems that such a circumstance is not entirely unheard of and so it may be a good thing to approach the CPT Editorial Board and request consideration. Either way, I would be certain that the documentation demonstrates the necessity of the visit in the absence of the patient, which would seem easy enough to do.
 
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