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A 14-year-old boy twisted his ankle while playing soccer. He received level 3 E/M services from his physician the next morning for which code 99213 was reported on the CMS-1500 claim generated immediately after the visit. The physician ordered an x-ray of the ankle, and the child left the office after the x-ray but did not see the physician. Later that afternoon the physician, an orthopedic surgeon, and a rehabilitation therapist met. The medical discussion was 45 minutes in duration. Assign the CPT code(s).
Case management services are the same as Chronic Care Management services.
Reporting participants of the medical team are not required to have face-to-face encounters with the patient being discussed as they are only consulting on the treatment plan.
Smith is a primary care physician who has been treating Ms. Johnson for diabetes. Ms. Johnson has been experiencing some complications and Dr. Smith feels that it would be beneficial to discuss her case with her other medical professionals. However, Ms. Johnson is unable to attend the conference due to other commitments.
Dr. Smith schedules a medical team conference with the patient’s endocrinologist, a nurse practitioner, and her dietitian. During the conference, they discuss Ms. Johnson’s condition, treatment plan, and any changes that may be necessary. They also discuss any test results, lab reports, or imaging studies that have been conducted.
The medical team conference lasts for 45 minutes, and all medical professionals involved document their participation and the details of the discussion. Assign the CPT code(s).
In order for the team conference service codes to be reported,