Pain Management Coding Alert

Question: Could you give me some insight into medical team conference code 99366? We have team conferences, but I’m unsure of whether I can code them.

Maine Subscriber

Answer: You would use 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 nonphysician qualified health care professional) to report a medical team conference.

Remember the following guidelines from CPT^®  when you report 99366:

• A medical team conference must include the face-to-face participation of at least three qualified healthcare professionals from different specialties or disciplines.
• Each participating physician must provide direct care to the patient.
• Participating physicians must be actively involved in “the development, revision, coordination, and implementation of healthcare services needed by the patient.”
• Each participating physician must have provided face-to-face evaluation/treatment for the patient in the 60 days prior to the medical team conference. The prior evaluation/treatment must have been an individual effort; it cannot include a team conference.
• The team conference should last at least 30 minutes.