chronic care management

  1. D

    Wiki Who needs an initiating visit before starting Chronic Care management?

    I see that an initiating visit is needed for certain patients before starting CCM (see Medicare statement below). It seems to me that the initiating visit is needed only for new patients or those not seen within the last year. Others in my practice interpret this as requiring an initiating...
  2. O

    Wiki How to Avoid Billing Overlap with PCPs in Specialist Setting

    I am currently assisting a specialist practice in implementing Chronic Care Management (CCM). These are CPT codes 99490, and 99439 While they understand that as specialists, they can bill for these services, they have concerns regarding potential overlaps in care with local primary care...
  3. R

    Wiki CCM and BCBS

    Is anyone seeing denials from BCBS for chronic care management where nothing else is billed on the same day but the denial is that the 99490 is "incidental to itself??" If so, how are you handling these? I am not really sure how something can be incidental to itself.
  4. M

    Wiki 99458 RPM / 99439 CCM

    CCM - Chronic Care Management threshold time is met at 15 minutes for the first 20 minutes. When "each additional" 20 minutes is met 99439 what is the minimum threshold? Provider(s) are stating is the same 15 minute rule is applicable, is this correct? RPM - Remote Patient Monitoring threshold...
    • mccoyheather
    • Thread
    • 99439 99457 99458 99490 ccm ccm time threshold chronic care management remote patient monitoring rpm time threshold
    • Replies: 5
    • Forum: E/M
  5. S

    Wiki Medicare CCM codes 99490 vs Care Management codes 98966,67,68

    Hello, I have been coding Chronic Care Management for almost 4 years. We use codes 99490 and 99439 (and rarely 99487). Within the past almost 2 years we have become PDCM certified so we began billing telehealth codes 98966,98967,98968 for PDCM eligible patients with BCBS, BCBS Medicare...
    • STKrueger
    • Thread
    • 98966 98967 98968 99439 99490 care management ccm chronic care management pdcm
    • Replies: 0
    • Forum: Billing/Reimbursement
  6. M

    Wiki billing RPM and CCM services for hospice patients

    Hello I have a few questions in regards to billing RPM and CCM services with patients who are enrolled in hospice; 1) Should patients in hospice be billed for this service at all? 2) If a patient has passed away in the middle of the month, can any of these codes still be billed (99453, 99454...
    • MagenD
    • Thread
    • billing chronic care management coding hospice remote patient monitoring
    • Replies: 1
    • Forum: Billing/Reimbursement
  7. K

    Wiki Chronic Care Management - Medicare Secondary

    Hello! If we have a patient with private BCBS as primary and Medicare Part B as secondary, can we still bill for Chronic Care Management? I am thinking yes, because they are technically a Medicare patient, but I can't find anything to say it's okay to bill this to a commercial payer. The...
  8. K

    Wiki CCM - Chronic Care Management questions

    Hello all, Our office would like to start billing for CCM and in looking at all the information out there, I still have some questions that I hope someone may be able to answer or direct me to help get the correct answer(s). In the questions below, let's assume we do have the patient's verbal or...
  9. W

    Wiki RPM + CCM + Interprofessional telephone/Internet assessment?

    Hi, I am trying to figure out if 99446-99449, 99451-99452 can be billed by a provider in addition to 99453, 99454, 99457 and/or 99458? Further, can 99446-99449 be billed in addition to Chronic Care Management codes 99487, 99490 + 99491? Are there any restrictions? The ultimate question: Can...
  10. B

    Wiki CCM code reimbursement 1/1/18

    We are a physician office that uses Care managers that utilize the CCM codes. We are not a hospital entity, but we are a look-a-like Federally qualified health care organization. We use eclinicalworks EMR that has a module for purchase to capture this documentation and charges to maintain...
  11. C

    Wiki Outpatient Provider Based Facility-CCM codes Reimbursement

    I am trying to find out the Part A facility reimbursement methodology for a provider based hospital owned outpatient clinic that is more than 250 yards from this hospital and started billing for services after November 2, 2015. My understanding is that starting in 2017, the above described...
    • cduhl
    • Thread
    • 2017 chronic care management outpatient provider based reimbursement
    • Replies: 6
    • Forum: Billing/Reimbursement
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