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Office Visit / Follow Up?

Nicole Posted Wed 14th of August, 2013 14:33:32 PM

If a patient (who is a minor) was scheduled for an appointment at the doctors office and did not come with the parent to the appointment to discuss the test results of an ultrasound that was done, is there anything that can be billed for this? The ultrasound was done at this doctors office. Would this just be considered a follow up/no charge visit?

There is going to be future procedures that will have to be scheduled in regards to the findings of the ultrasound. I am just not sure if anything can be billed when the patient was not actually in the office for this information.

SuperCoder Answered Mon 19th of August, 2013 19:58:26 PM

Based on CPT definition, the E/M codes apply to a “face-to-face with the patient and/or family.” The “or family” means the code technically can apply to a face-to-face visit with the family member. You would code based on time, with documentation of the counseling topic, the total visit time, and the time spent on counseling. Check individual payer guidelines, however, because some do require that the patient be present for the codes to be covered.

See the last 3 paragraphs of the article at http://www.aap.org/en-us/professional-resources/practice-support/coding-resources/pages/Coding-Tips-for-Pediatricians-Evaluation-and-Management-Coding-Strategies.aspx?nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

Also see: http://medicalassociationofbillers.yuku.com/topic/8535#.UhKjVD88s1I

Nicole Posted Mon 26th of August, 2013 11:17:49 AM

So, what I am gathering from the articles: you would bill the patient an E/M code and use the V65.19 code as a diagnosis?

SuperCoder Answered Mon 26th of August, 2013 18:07:29 PM

I agree on that.

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