Visiting the Medical
Genetics Clinic

Individuals are seen in the Medical Genetics Clinic for many different genetic conditions. Some individuals have a genetic condition and want to be followed by a physician who is familiar with their genetic condition. Other individuals have a family history of a genetic condition and want to be evaluated and have their risks assessed. Some individuals are seen for preconception genetic counseling prior to starting a family. There are over 5000 genetic conditions and with research advances, we are learning more about the genetic basis of different conditions. We have included in the “About Genetic Conditions” section web links to some of the more common genetic conditions seen in our clinic.

Scheduling Appointments

To schedule an appointment, please call (734) 763-2532. The Medical Genetics Clinic is held weekly on Thursday mornings. New patient appointments are typically 1 – 1½ hours. Generally patients are seen within 4-6 weeks, though this may vary depending on physician availability. If you are unable to keep your appointment, it is important that you let us know as soon as possible.

What Happens During Your Visit?

• Review of your family and medical history information
• Risk assessment
• Physical examination, if indicated
• Explanation of genetic condition(s) and patterns of inheritance
• Discussion of management, treatment, surveillance and testing options
• DNA testing, chromosome analysis or other genetic testing, if indicated
• Provision of information about support groups and other helpful resources
• Consultation with other specialists as needed
• Follow-up care

Generally, if you are being seen in our clinic for the first time, your appointment will last 1 - 1 1/2 hours. You will be seen by a geneticist (doctor who has specialized training in genetics) and our genetic counselor (master's level health care professional with specialized training in genetics and counseling) may see you as well. As the University of Michigan is a teaching hospital, we may also have genetic counseling and medical students with us in clinic. Geneticists and genetic counselors are board certified by the American Board of Medical Genetics (ABMG) or the American Board of Genetic Counseling (ABGC).

To prepare for your visit, we review the family and medical information that you have provided us and construct a pedigree (drawing of your family history information). We review the medical literature, use genetic databases and frequently consult with colleagues across the country. This preparatory work can take several hours and is critical to provide you with the most accurate and up-to-date information. A physical examination will be performed depending on the indication for the clinic visit and type of genetic condition. Most of the clinic visit is spent providing you with information about the genetic condition in understandable terms, discussing your care and linking you with appropriate referrals and resources, including local and national support groups. A letter will be sent to you and your physician summarizing the information that was discussed during your visit.

What is Genetic Counseling?

Genetic counseling is a communication process that translates medical information into understandable terms and addresses the implications of this information for the individual and their family. The goals of genetic counseling are to help individuals and their families:

• understand the genetic condition and how it is inherited
• provide comprehensive information so that informed health-care and life decisions can be made
• address the personal and family issues related to the genetic condition

Information Needed for Your Clinic Visit

Family History Form. A family history form will be mailed to you. It is very important that this form be completed and returned to us prior to your clinic visit so that we can provide you with accurate information, assess the risks to you and other family members, and address your questions and concerns. Click here to download Family History Form (PDF)

Medical Records. If you have a genetic condition or are being seen to rule out a genetic condition, pertinent medical records need to be sent to our clinic prior to your appointment. Contact us if you have any questions regarding specific records that are needed. If you are being seen because of a family history of a genetic condition, medical records documenting the genetic condition need to be obtained. We encourage you to contact relatives with the genetic condition but understand that it may not be possible to obtain their medical records. We will provide genetic counseling based on the information that you provide us. Click here download the Medical Records Release Form (PDF)

Your Questions. We encourage you to make a list of questions that you have and bring them to your appointment. Click the following link to download a helpful resource: "There’s No Reason to Face it Alone: Questions You May Have for Your Health Care Provider" (PDF)

Billing and Insurance Issues

Several insurance plans are accepted, including Medicaid and Medicare. Payment or a referral authorizing insurance coverage for the clinic visit is expected at the time of your appointment. If the University of Michigan is a participating provider with your health plan, your out-of-pocket costs are usually limited to co-payments, co-insurances and/or deductibles. When the University of Michigan is not a participating provider with your health plan, your insurance company will be billed as a courtesy to you but any amounts unpaid by your plan would be your responsibility.

If you have health insurance that requires a referral and/or authorization for services, please have the referral faxed to our clinic at (734) 763-7672. If you are unsure if you need a referral, please contact your primary care physician or health insurance. You may have been referred to our clinic by a specialist, who may have given you a consult form. A consult form is not the same as a referral form and you will likely need to contact your primary care physician for a referral form. For all patients, if you need a referral and do not have one at the time of your clinic visit, you will be asked to pay for services or sign a waiver stating you accept responsibility to pay for all clinic costs. If you are not able to cover the complete fees for the clinic visit, it is usually possible to work out a payment plan.

Click here for general information about University of Michigan Hospitals & Health Center’s billing policies.

For billing questions, please call (800) 914-8561. If the billing office is unable to answer your questions, please call our clinic at (734) 763-2532.

What billing codes are used for clinic visits?

The billing codes used for a clinic visit will depend on the amount of time that we spend with you, the complexity of the visit, the extent of the physical examination and review of medical history information and whether you self-referred or were referred to our clinic.

These are the billing codes that are commonly used:

Consultations: 992430 – 992450

New Patient Visits: 992030 – 992050

Established Patient Visits: 992110 – 992150

The diagnostic codes for a visit will depend on the indication for the clinic visit, whether you are being seen because you have symptoms, are at-risk or have a family history of a genetic condition(s). Sometimes, we may not be able to provide diagnostic codes prior to a visit because codes will depend on the results of the physical exam and/or analysis of your family history.

The codes for a genetic test will depend on the type of test and the laboratory that analyzes the sample. If genetic testing is a consideration, generally these codes will be provided during your clinic visit.

Am I at risk for genetic discrimination?

Your visit to the Medical Genetics Clinic, like other clinic visits, is part of your medical record. Some patients have expressed concern about how their medical information could be used by insurers and employers. For some patients who have no symptoms but are considering genetic testing to find out future risk, they may consider making sure that they have their desired insurance coverage prior to being seen in our clinic.

In 2000, Michigan passed laws which are intended to protect patients from genetic discrimination in health insurance and employment. Bills have also been introduced in Congress to pass national laws on genetic discrimination. While patients express concern about the possibility of genetic discrimination, studies have shown that there have been few documented cases of genetic discrimination.

To download the National Society of Genetic Counselors and FORCE (Facing Our Risk of Cancer Empowered) brochure, click here: “Genetic Information, Privacy & Discrimination: What You Need to Know". (PDF)

Laws/links regarding the use of genetic information

Michigan Genetics Connection – Policy & Law

Genetic Alliance - Resources on Genetic Discrimination

National Society of Genetic Counselors – Genetic Discrimination Resources

Your Medical Records

There will be a University of Michigan Hospitals & Health Centers medical record of your visit to our clinic. Your medical records are considered confidential. There are specific guidelines, known as HIPAA (Health Insurance Portability and Accountability Act) that describe how privacy is maintained with medical information. Click here to learn about HIPAA privacy practices, which also address your insurer’s access to your medical information, your right to see your medical records and other important issues.

How can I request copies of my medical records?

You may request copies of your University of Michigan Hospitals & Health Centers medical records by contacting the Release of Medical Information Unit. Specific information and written authorization is required to request copies of your medical records. Generally, medical records requested for continuation of care which are less than 30 pages are free of charge.

Click here for more information about obtaining your medical records.

Click here to download the Authorization to Release Medical Records Form. (PDF)

Release of Medical Information Unit
UMHHC
2901 Hubbard
Ann Arbor, MI 48109-2435
Phone: (734) 936-5490
Fax: (734) 936-8571

Maps, Directions and Accommodations Links

Our clinic is held on Thursday mornings from 8:00 am to 12:30 pm in the Taubman Center (third floor, reception area C), which is connected to the University of Michigan main hospital.

Maps and Directions

Taubman Center

Parking

If You Need a Place to Stay Overnight

Patient and Visitor Hotel Accommodations Program

The Med-Inn hotel is directly connected to all U-M Hospitals, and offers affordable accommodations to hospital visitors. For reservations at the Med-Inn, call toll free, 1-800-544-8684 or (734) 936-0100. Click here for more information about Med-Inn.

Click here for information about other overnight accommodations in the Ann Arbor area.

University of Michigan Hospital & Health System

General information about the University of Michigan Hospitals and Health System, directions, what to bring to your appointment are also available by calling the hospital operator atl (734) 936-4000. For referrals to other clinics at the University of Michigan, call the Physician Referral Service at (800) 211-8181.

Click here for more helpful information about the University of Michigan Hospitals & Health Centers.