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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 written consent, the patient does have 2 or more chronic conditions documented, these are Medicare patients and we would have a Chronic Care Management Coordinator that would call these patients to establish the care plans, go over the program and document the visit in our certified EMR.
1. Patient CCM visit is 44 mins from start to stop on one calendar day. Would we then bill the 99490 (20 mins) and also G2058 (each additional 20 mins) to account for the extra time? Or would it be more appropriate to bill 99491 (30 mins)?
2. Patient CCM visit is 63 mins from start to stop on one calendar day. Would we then bill the 99490 (20 mins) and also G2058 (each addition 20 mins X 2)? Or would it be more appropriate to bill 99487 (60 mins-Complex CCM)?
3. With the code 99487 (Complex CCM-60 mins.), what substantiates the difference in it and regular 99490 (CCM) other than time and moderate or high complexity medical decision making? What are some examples that would support moderate or high complexity medical decision making?
Thanks for any help or direction,
S. Chance
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 written consent, the patient does have 2 or more chronic conditions documented, these are Medicare patients and we would have a Chronic Care Management Coordinator that would call these patients to establish the care plans, go over the program and document the visit in our certified EMR.
1. Patient CCM visit is 44 mins from start to stop on one calendar day. Would we then bill the 99490 (20 mins) and also G2058 (each additional 20 mins) to account for the extra time? Or would it be more appropriate to bill 99491 (30 mins)?
2. Patient CCM visit is 63 mins from start to stop on one calendar day. Would we then bill the 99490 (20 mins) and also G2058 (each addition 20 mins X 2)? Or would it be more appropriate to bill 99487 (60 mins-Complex CCM)?
3. With the code 99487 (Complex CCM-60 mins.), what substantiates the difference in it and regular 99490 (CCM) other than time and moderate or high complexity medical decision making? What are some examples that would support moderate or high complexity medical decision making?
Thanks for any help or direction,
S. Chance
