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consults

SuperCoder Posted Tue 07th of June, 2011 20:08:14 PM

what code do you use to charge for a family consult in the office when the patient is not present?

SuperCoder Answered Tue 07th of June, 2011 21:33:11 PM

This can be regarded just an Office Visit and we can code the E/M level based on counseling/coordination of care provided the physician documents:
1) total time spent face to face w/ family
2) amount of time spent in counseling / coordination of care (must be MORE than 50% of total time)
3) nature of the counseling/coordination of care.

ADDITIONALLY, if the patient cannot participate in the session, your documentation SHOULD STATE WHY THE PATIENT IS NOT ABLE TO TO PARTICIPATE. Obviously the patient's age and health condition as mentioned above and the decision to opt for Hospicare is enough to if billed with these documentations.

It is highly probable that we may receive denial billing first time. In that case, we need to bill with appeal letter indicating the details.

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