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Written by: Darlene D'Altorio-Jones (1959-2015) on Monday, October 17, 2011 Posted in: Inpatient Rehab

The clarification documents written after the 2010 Regulations were implemented discuss the possibility of conducting team conference by phone. From the link I provided, at the bottom of the clarification document page,  you can open and reference the National Call Coverage, Series 4 document, pages 6 and  7, questions 23 and 24. These two questions discuss whether a physician may conduct team conference by phone.

It appears to me that it is reserved for times of absolute must and not a rule of performance. However, given the age we live in where medical records are available via internet and Web conferencing, where everyone can see and contribute to the documentation; I’m not so sure that Medicare can hold everyone to this strict interpretation for long.  There are so many viable concrete options taking hold in this age of “telemedicine.” This particular clarification will require further review very soon! We allow diagnostics, interpretation of radiologic exams and robotic surgeries that can be controlled miles away; surely team conference conducted via webinar, as long as connections are secured toward HIPAA compliance, will certainly come up for discussion soon.

These are the answers Medicare provides via the linked documents above:

23. Clarification regarding whether the rehabilitation physician can occasionally participate in the interdisciplinary team meetings by telephone.
Answer: As long as it is clearly demonstrated in the documentation in the IRF medical record that the rehabilitation physician was leading the interdisciplinary team meeting, he or she may conduct the meeting by telephone.

We understand that it may occasionally be difficult for the rehabilitation physician to be physically present in the meetings. The specific reasons that the rehabilitation physician led the
interdisciplinary team meeting by telephone rather than in person must be well-documented in the patient?s medical record at the IRF.

24. Clarification regarding the documentation of the rehabilitation physician?s participation in the interdisciplinary team conference if the rehabilitation physician led the meeting via telephone from an offsite location.

Answer: It must be clear in the documentation that the rehabilitation physician led the interdisciplinary team meeting, as required in the regulation, even if the rehabilitation physician called into the meeting by telephone. One of the participants of the interdisciplinary team meeting must document in the IRF medical record that the rehabilitation physician led the team meeting by telephone and the reasons why. The rehabilitation physician must confirm this documentation in the IRF medical record when he or she returns to the IRF. In addition, the rehabilitation physician must document concurrence with all decisions made by the interdisciplinary team at the team meeting.”