Pediatric Coding Alert

Question: How should we code for a team conference? Several providers are meeting regularly to discuss treatment for a 6-year-old leukemia patient in our facility. How should we report their meetings?

Pennsylvania Subscriber

Answer: Team conferences are frequently part of the care that long-term care patients receive in inpatient settings.

You should report coordinating care with other providers or agencies without a patient encounter on that day with the case management services codes. Team conferences with the patient or family present, however, would be coded with the appropriate E/M code.

Use 99361 (Medical conference by a physician with interdisciplinary team of health professionals or representatives of community agencies to coordinate activities of patient care [patient not present]; approximately 30 minutes) for 30-minute conferences and 99362 (... approximately 60 minutes) for conferences lasting an hour.

Clinical and coding information for You Be the Coder and Reader Questions provided by Richard Tuck, MD, FAAP, practicing pediatrician with Primecare Pediatrics of Zanesville, Ohio; Jeffrey Linzer Sr., MD, MICP, FAAP, assistant professor of pediatrics at Emory University, and EMS coordinator at Children's Healthcare of Atlanta and Hughes Spalding Children's Hospital; Richard Molteni, MD, FAAP, a neonatologist and member of the American Academy of Pediatrics (AAP) national committee on coding and nomenclature (COCN); and Patricia Wildman, RHIA, clinical reimbursement auditor at Children's Hospital in Boston.