Hi Rebecca,
Yes this code looks as though it is the one that would be used. Would each physician involved in the conference bill this and document his participation? Also, if the physician has not seen the patient, is he exempt from billing this?
Would the facility report the same code?
Thanks for your time!
Your question: Would each physician involved in the conference bill this and document his participation?
Answer: Yes; however, no more than one individual from the same specialty may report codes 99366-99368 at the same encounter. Reporting participants must document their participation in the team conference as well as their contributed information and subsequent treatment recommendations.
Your question: If the physician has not seen the patient, is he exempt from billing this?
Answer: Yes-Reporting participants shall have
performed face-to-face evaluations or treatments of the patient, independently of any team conference,
within the previous 60 days. This contact can have occurred in any setting.
Your question: Would the facility report the same code?
Answer: Individuals
should not report codes 99366-99368 when their participation in the medical team conference is part of a
facility or organizational service contractually provided by the organizational or facility provider. Example, payment for a rehabilitation hospital stay may include the services when the rehabilitation care team meets to review goals, progress, and discharge plans. (I don't do facility billing-there may be more to this answer)
Someone chime in if I've left anything out...
