Wiki Chronic Care Management

[lcouto]

We have begun with billing chronic care management and are getting some denials on the Cpt Code 99490 because the date that the monthly charge is billed, the patient was in the hospital... Has anyone run into this problem? Is there a modifier that should be used? Any help is greatly appreciated....

 

[suemt]

One of the objectives of CCM is to keep patients out of the hospital. It they are hospitalized, providers may bill CCM in the following calendar month, or Transitional Care Management services, after discharge, if the requirements are met. Do you have access to the guidelines in the CPT book?