General Surgery Coding Alert

Rumored -e-visit- code arrives When you open your CPT 2008 manual, you-ll be confronted with a dozen new evaluation and management codes, along with fewer deletions and some minor revisions. Here's the information you-ll need to adapt your E/M coding when Jan. 1 rolls around. Look for Replacement Team Conference Codes Fully half the new E/M codes are replacements for codes removed from CPT 2008. For instance, CPT has deleted medical team conferences codes 99361 and 99362 and replaced them with three all-new codes: - 99366 -- Medical team conference with interdisciplinary team of healthcare professionals, face-to-face with patient and/or family, 30 minutes or more, participation by nonphysician qualified healthcare professional - 99367 -- Medical team conference with interdisciplinary team of healthcare professionals, patient and/or family not present, 30 minutes or more; participation by physician - 99368 -- - participation by nonphysician qualified healthcare professional. Codes 99366-99368 differ from their predecessors 99361 and 99362 in several ways. Most important, 99366 and 99368 apply to nonphysician healthcare professionals (NPPs), such as a nurse, nurse practitioner, physician assistant, etc. Both code descriptors specify a minimum service time of 30 minutes or more, but 99366 also stipulates that the patient and/or family be present during the conference. "Codes 99366 and 99368 were added to allow inclusion of nonphysician, qualified healthcare professionals," says Susan E. Garrison,-CHC, PCS, FCS, CCS-P, CPAR, CPC,-CPC-H, executive vice president of Healthcare Consulting Services. Patient presence matters: Many payers, including Medicare, will not reimburse separately for non-face-to-face services -- which means insurers will likely not recognize 99368 (during which the patient and/or family is not present) as a payable service. There is a possibility, however, that payers may choose to accept 99366 if an NPP in your practice takes part in a team conference for a patient in your care, as long as the patient and/or family is involved. Code 99367 also requires a service time of 30 or more minutes, but applies when a physician (rather than an NPP) participates in the team conference. In this case, the patient and/or family are not present. Previous codes 99361 and 99362 also described physician participation in a team conference, but because those codes specified "patient not present," Medicare and other payers would not reimburse for the services. Code 99367 is likewise not a face-to-face service, and payers consequently will almost definitely not pay for it. Reporting advice: Documentation will be key when reporting team conferences, Garrison says. She suggests that for each service, physician notes should specify: - Who participates in the conference (the specific providers with credentials).-Remember, only one same-specialty, same-practice professional may bill per conference. - Time of participation.-This must begin at the start of the review for an [...]