Correct Medical Billing for Parent Consultations

The world of pediatric medicine is fast paced and along with unpredictable kids come unpredictable medical billing situations. If you process medical billing for pediatric physicians, you may or may not have run across a situation for determining what diagnoses would apply when parents come in to discuss their child’s health issues.

If you’re wondering if there is a single code, the answer is yes. A parent conference falls under V65.19 (Other persons seeking consultation; other person consulting on behalf of another person). In other words, the code describes a person seeking “advice or treatment for non-attending third party.” Since a parent has the right to discuss the treatment and medical issues for their minor child it’s per missable to bill for the consultation.

The counseling diagnosis code can be used when the patient is present or when counseling the parent/guardian(s) when the patient is not physically present as in over the telephone. Although carriers may require supporting documentation for coverage of the encounter, so make sure you indicate the discussion’s topic and the documentation should be signed off on by the attending physician. In case of an as yet undiagnosed concern, you can also check if payers want a secondary diagnosis that indicates the topic.

There are numerous reasons for consultations that include these top four common reasons:
* ADD/ADHD — 314.00, Attention deficit disorder; without mention of hyperactivity; 314.01, Attention deficit disorder; with hyperactivity
* anxiety — e.g., 300.00, Anxiety state, unspecified
* depression — e.g., 311, Depressive disorder, not elsewhere classified
* obesity — 278.00, Obesity, unspecified.

Use the total face-to-face time that the pediatrician spends with the parents to select the service code. Careful supporting documentation of the time elements is critical and will result in reimbursement for your medical billing claim.

View all Articles by: Melissa C. - OMG, LLC. CEO