fnichia
New
When billing Transitional Care Management Services 99495 or 99496 can the direct contact (phone/email) within the 2 days after discharge be done on the day of discharge? My provider is also the discharging provider.
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Wiki Transitional Care Management 2 day contact
- Thread starter fnichia
- Start date
julesmit
New
Are you asking if you can bill the TCM code on the same day as a discharge code, or just contact the patient?
Thanks!
Thanks!
fnichia
New
Just contact the patient. We need to contact the patient within two days for transitional care management but in some cases our staff is calling them later on the same day as discharge. I'm assuming that is has to be the day after since the discharge codes cover all services on that date.
CMS has a great tool www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Transitional
and also frequently asked questions.
Frequently asked questions by CMS has this which tells me you can make that phone contact later in the day on the date of discharge. It has to be from a licensed staff of the physician office.
1) AN INTERACTIVE CONTACT
An interactive contact must be made with the beneficiary
and/or caregiver, as appropriate, within 2 business days
following the beneficiary’s discharge to the community
setting. The contact may be via telephone, email, or
face-to-face. It can be made by you or clinical staff
who have the capacity for prompt interactive communication
addressing patient status and needs beyond scheduling
follow-up care
FREQUENTLY ASKED QUESTIONS
If a patient is discharged on Monday at 4:30, does Monday count as the first business day and then Tuesday as the second business day, meaning that the communication must occur by close of business on Tuesday? Or, would the provider have until the end of the day on Wednesday?
In the scenario described, the practitioner must communicate with the patient by the end of the day on Wednesday, the second business day following the day of discharge. If two or more separate attempts are made in a timely manner and documented in the medical record, but are unsuccessful, and if all other TCM criteria are met, the service may be reported. We emphasize, however, that we expect attempts to communicate to continue until they are successful, and TCM cannot be billed if the face-to-face visit is not furnished within the required timeframe.
hope this helps
Sheila Sweetland
and also frequently asked questions.
Frequently asked questions by CMS has this which tells me you can make that phone contact later in the day on the date of discharge. It has to be from a licensed staff of the physician office.
1) AN INTERACTIVE CONTACT
An interactive contact must be made with the beneficiary
and/or caregiver, as appropriate, within 2 business days
following the beneficiary’s discharge to the community
setting. The contact may be via telephone, email, or
face-to-face. It can be made by you or clinical staff
who have the capacity for prompt interactive communication
addressing patient status and needs beyond scheduling
follow-up care
FREQUENTLY ASKED QUESTIONS
If a patient is discharged on Monday at 4:30, does Monday count as the first business day and then Tuesday as the second business day, meaning that the communication must occur by close of business on Tuesday? Or, would the provider have until the end of the day on Wednesday?
In the scenario described, the practitioner must communicate with the patient by the end of the day on Wednesday, the second business day following the day of discharge. If two or more separate attempts are made in a timely manner and documented in the medical record, but are unsuccessful, and if all other TCM criteria are met, the service may be reported. We emphasize, however, that we expect attempts to communicate to continue until they are successful, and TCM cannot be billed if the face-to-face visit is not furnished within the required timeframe.
hope this helps
Sheila Sweetland