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medical team conference code 99366

  1. Default medical team conference code 99366
    Medical Coding Books
    My provider (MD) met with family members and two other hospital employees (ethics committee members) for an ethics consult on an inpatient. The reason for the conference was that the patient is not expected to improve, doctor is recommending palliative care and patient refuses...wants everything possible done.

    the other two committee members are an RN and a clergy member, both of whom are seeing the patient in the hospital

    does this qualify as a medical team conference with direct contact with patient and/or family member?
    CPT says the team must be certified health care professionals
    If not a team conference, then what E/M code should be used?
    Diane Bartlett, CPC

  2. #2
    Based on CPT this would not qualify for the medical team conference.

    All of the participants of the conference have to provide direct care to the patient, also if either the patient or family is present CPT states to use E/M service codes.

    Laura, CPC

  3. #3
    Milwaukee WI
    Default 99231-99233
    You can use the subsequent hospital visit code, based on total time spent with more than 50% in counseling/coordination of care.

    Your documentation must meet the counseling/coordination of care guidelines.

    15 minutes total time 99231
    25 minutes total time 99232
    35 minutes total time 99233

    F Tessa Bartels, CPC, CEMC

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