Do you ever meet with parents before their baby is even born? In these cases, you might be hesitant to charge for the visits because the patient isn’t present yet—but can you collect anything for the physician’s time? Check out the following 4 options, along with our expert advice before billing to insurance.
1. Consider an Office Visit
Some practices think of meet-and-greets, in which they tell the parents about the way they run their practice, more as an office visit, such as 99201. However, this would need to be billed based on time to the mother’s insurance company and would likely be questioned by the insurance company. For practices that do charge for these services, there’s a diagnosis code you can use: V65.11. ICD-9 guidelines allow you to list the code as a first or additional diagnosis.
2. Ensure You Meet Criteria Before Using 99401-99404
As an alternative to use a problem-oriented office visit code, the American Academy of Pediatrics (AAP) suggests the pediatrician may deem an appropriate counseling or risk factor reduction code. You may report these codes for prenatal counseling “if a family comes to the pediatrician/neonatologist either self-referred or sent by another provider to discuss a risk-reduction intervention (i.e., seeking advice to avoid a future problem or complication),” according to the AAP’s Coding for Pediatrics 2009.
You would report the service under the mother’s insurance, according to the AAP. Make sure you don’t use 99401-99404 if the mother or her fetus has any existing symptoms, an identified problem, or a specific illness. As per CPT®’s Counseling Risk Factor Reduction and Behavior Change Intervention guidelines, “these codes are used to report services for the purpose of promoting health and preventing illness or injury.”
Codes 99401-99404 aren’t necessarily shoo-ins for typical meet and greets. The AAP gives…