Patient was scheduled for a follow-up visit and parents came to discuss treatment plan without the child. We were not aware they would be coming without the patient and the Dr. spent almost 30 minutes discussing treatment plan. What E/M code would be appropriate?
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Wiki OV-Conference w/parents without patient present
- Thread starter karen1123
- Start date
BenCrocker
Guest
Barring full documentation the best CPT code I found was 99242. If you read the small print it says "Usually the presenting problems are of low severity. Typically, 30 minutes are spent face-to-face with the patient and/or family." I picked this because of the 30 minute consult. And if you notice my bolded section the patient doesn't always have to be present.
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mhstrauss
True Blue
I agree that, per CPT description, patient doesn't need to be present, as stated above, but you need to check with the payer. Medicare will not pay a visit without the patient present. But some commercial payers will--we have gotten guidance in writing from our major payers, and some will. But I would go with an establ patient code, since it is a follow up, not a consult. 30 min visit = 99214.
Just my $0.02!
Just my $0.02!
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BenCrocker
Guest
My first CPT code I guessed at was 99214 but then I second guessed myself. Plus I fell into the Apprentice trap of not reading the first section heading. Silly me.
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