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EM Coding Alert

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Coding a Team Conference With Family Present

Published on Fri Jan 30, 2015

Question: A mid-level provider (MLP) in our office met with a patient’s family member as part of a team conference to discuss the patient’s care. Is the most appropriate team conference code to use 99367?

Alabama Subscriber 

Answer: No. You should code 99366 (Medical team conference with interdisciplinary team of health care professionals, face-to-face with patient and/or family, 30 minutes or more, participation by non-physician qualified health care professional) because the family is present. Coding 99367 (… patient and/or family not present, 30 minutes or more; participation by physician) specifically says that the patient and/or family isn’t present.
 
Caveat: Be aware that many payers, including Medicare, won’t reimburse without a face-to-face with the patient. 
 
The documentation will have to include the following specific information:
  • Who took part in the conference, only one physician per specialty, from one practice may bill per conference
  • The time of the conference
  • Was the patient present
  • What is the plan going forward
  • What are the treatment goals
  • What rehabilitation treatment is ordered
  • Are there any referrals. 

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