You Be the Coder:
Coding a Team Conference With Family Present
Published on Fri Jan 30, 2015
Question: A mid-level provider (MLP) in our office met with a patient’s family member as part of a team conference to discuss the patient’s care. Is the most appropriate team conference code to use 99367?
Alabama Subscriber
Answer: No. You should code 99366 (Medical team conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more, participation by non-physician qualified health care professional) because the family is present. Coding 99367 (… patient and/or family not present, 30 minutes or more; participation by physician) specifically says that the patient and/or family isn’t present.
Caveat: Be aware that many payers, including Medicare, won’t reimburse without a face-to-face with the patient.
The documentation will have to include the following specific information:
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Who took part in the conference, only one physician per specialty, from one practice may bill per conference
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The time of the conference
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Was the patient present
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What is the plan going forward
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What are the treatment goals
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What rehabilitation treatment is ordered
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Are there any referrals.
