I have a question from a provider I need some assistance with. He saw a patient in the office the day after an acute care discharge. The contact was not made to the patient prior, so he was not able to bill CPT codes 99495-99496. His question is, can he bill codes 99495-99496 the following week at the patient's next visit? And, would the office visit the day after discharge count as contact with the patient? I've been researching this, but I'm not having very much luck finding an answer. Thanks for your help!
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Wiki TCM codes 99495-99496
- Thread starter KelseyK08
- Start date
mitchellde
True Blue
the first contact with the patient within the 2 day time frame can be a face to face, or phone or e-mail. so yes that visit can count but you do not charge the visit level, then the visit that meets the 7 or 14 day criteria will not be charged separately either, however any other visits during the 30 days can be billed as office visits. read the instructions in the CPT book that goes with these codes for a thorough understanding.
Thank you for your response. I understand not billing for the initial visit, but wouldn't I be able to bill the TCM code if the patient was seen within 14 days of discharge and not just a regular E/M code? The visit the day after would count as contact and a no charge, then the visit the following week would be the TCM visit and I would bill this with a DOS that was the 30th day after discharge? Thanks
mitchellde
True Blue
yes as long as you have met all the qualifications not just the visits.