Wiki Well Newborn + Addt'l Problem for mother

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CrysLednum

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Hello -

I have a 5 day old newborn coming in for a well visit. Peds performs the required exam and during the visit, mother bursts into tears. Physician counsels and talks to mom about "feeling down and overwhelmed."

Physician wants to code an E/M for this counseling where postpartum group info was given along with discussing famiy support, counseling, anti-depressents, etc.

Two-fold question:

1. Is is appropriate for Peds to bill for visit w/Mom?
2. Depression has not been formally diagnosed. Would V65.49 (other counseling, other specified) be appropriate if billable?

Thanks.
 
Bill Mom's care under HER name

If the physician provided service to the patient (in this case Mom), then yes, it is appropriate to code and bill that service per documentation. Of course, the service would be billed to Mom's insurance with Mom as the patient.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
CrysLednum said:
Hello -

I have a 5 day old newborn coming in for a well visit. Peds performs the required exam and during the visit, mother bursts into tears. Physician counsels and talks to mom about "feeling down and overwhelmed."

Physician wants to code an E/M for this counseling where postpartum group info was given along with discussing famiy support, counseling, anti-depressents, etc.

Two-fold question:

1. Is is appropriate for Peds to bill for visit w/Mom?
2. Depression has not been formally diagnosed. Would V65.49 (other counseling, other specified) be appropriate if billable?

Thanks.
Click to expand...

I think you might run into an issue billing for "counseling" services for Mom when your provider's expertise is Pediatrics. Part of the services provided to newborns involves checking on the status of the family as a whole. Suggesting other services for mom to check into due to possible postpartum depression would not constitute an additional service. Do you bill additional services when talking with the mom about breastfeeding?
 
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