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Next Reply: Re:PC Physician Reimbursement for Family Meetings
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Post PC Physician Reimbursement for Family Meetings
Author: HPM_Physician
Date: Mar 26, 2008 8:49 am
As we all know, there are occasions where a palliative care consult is needed for a family meeting to discuss "Goals of Care". If there are no symptoms to manage and/or the requesting physician is symptom managing then my questions are:
1. For the initial visit/meeting can we use the primary diagnosis code for reimbursement (I heard you can use the primary diagnosis code for the initial visit only but not subsequent visits)?
2. If we are not able to use the primary diagnosis code for initial or subsequent visits and we are not managing any symptoms, what code can we use to bill?
Replies: order by [Date] [Author] [Subject]
Re:PC Physician Reimbursement for Family Meetings (by TomSmith on 04/07/2008)
1. USe the most appropriate diagnosis code. If the cardiologist bills for CHF and the nephrologist bills for CHF, then they both should get paid. Same for PC.
2. Add whatever other symptom codes (dyspnea, etc.) the person has. If they didn't have some symptoms, you wouldn't be there consulting. Even debility or asthenia or malnutrition is OK.
3. Don't use the family meeting code, even if there is one. Medicare pays $0 for it, as do most insurers. Work the family meeting into your consult and document same.

Thomas J. Smith, MD
Professor and Chair, Division of Hematology/Oncology and Palliative Care
VCU-Massey Cancer Center
Palliative Care Leadership Center

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