Town & Country Pediatrics & Posted Mon 10th of June, 2013 15:27:09 PM
A parent of a large family came into the office with two sick children who were then diagnosed with and treated for Strep. The doctor also prescribed antibiotics for the rest of the siblings who were not present. This entailed going into each sibling's chart and checking their medications and their history and then performing some decision-making. Is there any way to bill for these siblings who were not actually present in the office? Codes 99212-99215 allow the face-to-face time to be with a family member, but since these patients do not have an actual diagnosis, the doctor wants to bill 99401 with a diagnosis of 401.89 - exposure to strep. What is the correct way to go about billing for these patients?
SuperCoder Answered Wed 12th of June, 2013 04:22:42 AM
My editor is working on your case. She will respond you soon.
SuperCoder Answered Wed 12th of June, 2013 22:06:18 PM
The physician is doing real work, but it is not for the patient being seen. This would not be a billable service. Additional time based coding could be done if it is related to counseling and coordinating care for the patient and parents related to the patient's problem. In particular, 99401 would not be appropriate. This is a code for non problem related counseling, (preventive medicine counseling, ie anticipatory guidance). It should also be related to the patient being seen face to face.
There is no appropriate way to bill for the non face-to-face work being provided to the siblings who are not present.