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Medicare - counseling family member

Karen Posted Tue 10th of January, 2012 15:09:50 PM

If a team conference was perfromed 25 minutes - with the care giver, GIM MD, Neurolgy MD & social worker. Can we bill for an office visit - if a time statement is added. The patient was not present (Medicare patient) Patient has cerbral pulsy - CPT book says to use regular e/m if MD performs visit of less than 30minutes.

SuperCoder Answered Thu 16th of February, 2012 13:40:17 PM

When you will go for current CPT manual on page #33, there are two codes for Medical Team Conference, Without Direct (Face-to-Face) Contact With Physician and/or Family 99367 and 99368.
CPT 99367 is applicable for participation of physician, patient and/or family not present, for 30 minutes or more and CPT 99368 is for participation of nonphysician qualified healthcare professional.
So here qualified physician with social worker are present, you should code 99367. Again, as the timing are the most important factor, you can't code code it as documentation is for 25 minutes. You would have coded it if it would have 30 minutes or more. It is clearly meantioned under code 99368 that (services less than 30 minutes duration are not reported separately).

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