Case manager code

[LAURENC]

Hello,
What code would we use if a patients case manager came with the patient and has an appointment after the patient, to discuss the patient with the doctor?

Thank you!

 

[Pam Warren]

I'm assuming you want to bill for the case manager. I'm assuming also that the case manager is an RN or other non-physician provider? Remember, you can bill only for those providers who are credentialed with the payers. Unless the case manager is a physician or mid-level (with payer credentials), you cannot bill for their services, other than incident-to in your own practice setting. There are time-based care management codes, but they involve documentation of specific care plans and require certain criteria to be met. This instance wouldn't meet the criteria.