Interdisciplinary Team Conference Billing

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Interdisciplinary Team Conference Billing

Postby JJones » Wed Jan 24, 2018 4:53 pm

Hello! Thank you in advance for any help you can provide - we have a provider of Inpatient Rehab Services that has the following question. Due to some time constraints, we would like to get an answer back to him as soon as possible.

His question is:

"Three days per week, including Tuesdays, we do patient care conferences on inpatient rehab (required by PPS). What we usually do is bill the patient on the days of his/her conference is document that we put in 35 minutes or more and then charge for a level 3 visit for that day. Now that I’m in the pain clinic on Tuesday afternoons, another provider in this practice attends the patient care conference for the people who will be conferenced while I’m gone. How should we bill for this? Should I charge for the basic progress note (level 2) and leave it go at that, or is there a separate code somewhere which would allow me to charge for the progress note and him to charge for the conference note? The patient care conference is an interdisciplinary conference attended by the patient’s treatment team and is always well documented in the chart".

Thank you,
JJ
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Re: Interdisciplinary Team Conference Billing

Postby admin » Wed Jan 31, 2018 4:48 pm

Based on the wording of the question it seems as if the patient is not present when this care team gets together. Because of that an E/M service of a level 2 or 3 is not billable and would not appropriate.

When billing for a care team it is important that the members of the team are actively involved in the patients treatment.
There are is a set of code that is billable specifically when a care team is treating the patient. The codes are found in category 99366-99368, and are time based codes. These are determined on whether the patient is present or not and whether it is a physician team or non-physician team.

The question posed stated '35 minutes', I want to point out that codes from category 99366-99368 are timed codes, so in order to code for this service the time spent in that conference has to be for the specific patient you are billing. For example you could not spent 35 minutes in a conference discussing 6 patients, then bill all 6 patients for 30+ mins from the care team.

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

99367 Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by physician

99368 Medical team conference with interdisciplinary team of health care professionals, patient and/or family not present, 30 minutes or more; participation by nonphysician qualified health care professional

In the original question it also sounded like a physician was trying to code for both a subsequent E/M and the team conference. They would need to be present for the team conference to get credit for that on that date. Time reported for medical team conferences may not be used in determination of time for other services such as care plan over sight, psychotherapy, or and e/m service.

If the patient is seen separate from the team conference and a separate daily progress note supports it, a subsequent E/M could then be billed, but that is not a separate service that does not involve time spent with the conference team.

Your question has been answered by Stephanie Allard, CPC, CEMA, RHIT
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