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#1
06-26-2012, 12:52 PM
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99366
Need some insight on 99366.
We see doctors billing this for when a case manager is at the E/M visit or when they visit a patient at their homes. Both being billed as often as on a weekly basis! Correct me if I'm wrong, but isn't a doctor supposed to use an E/M code for these visits? If they do qualify for 99366, can they bill 2 units for 60 minutes? How often would 99366 be used and be considered 'reasonable and necessary'? Very confused about the use of 99366!!! Tina Boback CPC 
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#2
06-26-2012, 03:45 PM
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99366 is for nonphysician qualified health care professional when there is a team conference of health care professionals (face to face with patient and/or family member). The doctors in this team must have performed a face to face evaluation or treatment of the patient, independent of any team conference, within the previous 60 days.
Your providers should be charging and E/M when the patient is seen at the office. If the provider is at the patients home you can look at codes 99374-99380. Show your doctors the medical team conferences guidelines on page 33 of your CPT book if they need documentation. Hope this helps. 
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