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Multidisciplinary Consultation

  1. #1
    Default Multidisciplinary Consultation
    Medical Coding Books
    How would the physician bill for a multidisciplinary consultation, ie: medical & radiation oncologist, oncologic surgeon, etc. AND how would the hospital bill for it? The services would be performed in an out-patient facilty. I can't locate CPT code either? All information will be appreciated!

  2. #2
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    Look at the Medical Team Conferences section and see if this fits your scenario...

    99366-99368

  3. #3
    Default Multidisciplinary Conference
    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!

  4. #4
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    Quote Originally Posted by KMayercsik View Post
    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...
    Last edited by RebeccaWoodward*; 04-22-2010 at 12:40 PM.

  5. #5
    Default Another Question on Conference
    Hi Rebecca:

    I presented the codes at a meeting this afternoon. The director wants to know what if no one in the conference has yet seen the patient. I guess that they want to do a Breast Clinic, where the surgeon sees the patient and discusses the case with the Oncologists (radiation/medical). They then bring in the patient to discuss the case. I have asked the director for an exact scenario, have you ever heard of this?
    I just received my CPC on 4/3/10.

  6. #6
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    I have sent you a PM (private message)

    and...CONGRATS on your test!

  7. #7
    Location
    North Carolina
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    Your comment:

    "They then bring in the patient to discuss the case."....

    Face-to-face medical team conferences are reported by physicians using the appropriate E/M code based on the setting in which the service occurs. It may also be appropriate to append a prolonged service code to the E/M code when the team conference extends beyond the time parameters designated by the E/M code.

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