CPT coding assistance

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xavier2000

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Wonder if I could get some coding wizards to assist - just looking for most RVU :D

14 yo pt comes in with mom, dad, step mom. Pt spends alternating weeks with mom and then dad.

Been having worsening messages from dad who has never come to a clinic visit. Recent was essentially, what the F are you doing putting my son on Risperdal; it causes infertility?

Mom has new step son that was in that same day and told her about continued issues with dad's messages. I am reaching the point where I want to tell them I want only one parent to contact for decisions with regard to care.

To try and avoid that informed them I wanted to see mom and dad at clinic visit. I had social worker join for the clinic visit. Time all together was about 2h 15m.

The E&M alone would be a 99214. I would say 2 hours was for family session.

What is best way to legitimately code the visit?

90838 maxes at 2.5 RVU. Would outpatient prolonged services 99354 plus 2x 99355 be it? So total 99214 x1, 99354 x1, 99355 x2?

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Finally, the patient must have been present for the entire duration.
I don't think this part is true. For minors, parents count for face-to-face time.
 
I think that bills as "The Jerry Springer Show."


Edit: Seriously though, I don't care about a lot of social issues but people who can't keep it together to give a kid a single household until they're 18 maybe need a religion. And I'm not religious. The ego to think their personal fulfillment and love life have any relevance to the needs of children who didn't even ask to be brought into this world staggers me. Can they not wait a decade. If I got to play God/psychiatrist I'd tell each spouse to go back to the one they originally married and stay a family until the kid is 18. Again not religious, but for the sake of children I like that rule in the Bible about remarrying being an affair. If there are no kids, I don't care.
 
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