tci General Surgery Coding Alert - 2004 Issue 11

Reader Questions: Consider Family Consult a Patient Service

Question: A patient comes in to discuss the care of his wife, who is also a patient and whom the surgeon is treating for breast cancer. The surgeon spent 30 minutes with the husband, describing treatment options, possible outcomes, etc. Because the wife isn't present, may I bill the visit?Arizona Subscriber Answer: The E/M codes include "face-to-face with the patient and/or the family." But most private payers follow Medicare's policy and don't cover encounters in which the patient isn't present. Most insurers reimburse only for services that the physician delivers directly to the patient unless the patient...

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