Probably, if the provider is going to be treating the patient for the chronic disease, and the discussion leads up to a decision regarding care, then there is likely medical necessity. Your scenario is vague. So what your saying is that there may have been something like a remote event monitor report for cardiac events such as a-fib, and the cardiologist is reviewing the findings and determining a treatment plan--then of course he/she could bill an E&M, even if he/she didn't place or order the monitoring and may only initiate further care.