tci E/M Coding Alert - 2022 Issue Q3

Reader Questions: Understand Circumstances Where Patient May be Absent

Question: A patient’s family came in, and our pediatrician spoke to them about the child’s diagnosis and made a plan with the family. Can this be billed if the child was not present due to the child’s age and diagnosis? AAPC Forum Participant Answer: Yes, it is perfectly possible to bill for an appropriate level of office/outpatient evaluation and management (E/M) service in situations like this. That’s because CPT® defines total time for office/outpatient evaluation and management (E/M) services as including “counseling and educating the patient/family/caregiver.” Under this situation, family counseling without the...

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