Cardiology Coding Alert

Question: I know that typically the physician establishes a care plan in chronic care management (CCM) but are there any circumstances where that can be done by clinical staff?

AAPC Forum Participant

Answer: Yes, there are circumstances where the establishment of a plan can be performed by clinical staff. For example, a physician might identify a patient who is a good candidate for CCM during an office visit. The patient agrees to receive CCM services, but the physician doesn’t have time right then to develop the care plan (e.g., because the physician’s schedule is booked solid for a long time, he/she is leaving for vacation later that day, etc.). So, the physician might delegate the establishment of the plan to an appropriate clinical staff person (e.g., nurse care manager). Later, that physician will need to review the plan and either confirm it meets expectations or make necessary adjustments.