how to code a patient visit when the patient is seen by two physicians


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I have a family practice physician who "shares" her adolescent patient visits with a specialist. Typically she writes a referral to the specialist and puts it in the chart. She starts the visit then the specialist comes into the exam room and does his/her part of the visit then writes a note in the chart. After the specialist is finished, the family practice physician consults with the specialist in the room with the patient about the course of treatment. She then writes a summary note in the chart as well.

In another scenario the family practice physician starts the visit. A resident will then examine the patient along with the specialist and the family practice physician in the room. The specialist may or may not write a note in the chart. The family practice physician reads the resident's notes and discusses the care plan with the resident and the specialist. She then writes a summary note about the total visit in the chart.

On top of all of this these specialists are volunteers and are not paid for their services. They are not credentialled with any of our payers. At the moment we do not bill them as the performing providers. We bill under the family practice physician who starts the visit.

Any advice would be greatly appreciated.