Wiki transitional care management ( TCM)

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jbhuju

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hello ,
i need help on how to bill TCM 99495 and 99496 codes. if clinical staff tried to call twice toget hospital discharge info but are unsuccessful to get hold with patient can we still bill TCM? on norodian i see if even second try patient can not gey hold of but all requirement are there to bill TCM we can bill and also see that patient must be contacted within 2 days of discharge if cant talk with patient we can not bill TCM. could anyone please on how to bill TCM. thank you
 
jbhuju said:
hello ,
i need help on how to bill TCM 99495 and 99496 codes. if clinical staff tried to call twice toget hospital discharge info but are unsuccessful to get hold with patient can we still bill TCM? on norodian i see if even second try patient can not gey hold of but all requirement are there to bill TCM we can bill and also see that patient must be contacted within 2 days of discharge if cant talk with patient we can not bill TCM. could anyone please on how to bill TCM. thank you
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Clinicians must make interactive contact within 2 business days following the patient discharge to the community setting. The contact may be via telephone, e-mail, or a face-to-face visit within two business days.

For Medicare purposes, attempts to communicate should continue after the first two attempts in the required 2 business days until they are successful.

A successful attempt requires a direct exchange of information and appropriate medical direction by clinical staff with the patient and/or caregiver.
 
Hello JBHUJU,:)
Providers can extract greater value from transitional care management (TCM). CPT codes 99495 and 99496 support management and coordination of services for moderately complex patients and highly complex patients, respectively, following discharge from hospitals, long term care and skilled nursing facilities, and other inpatient settings. Ensure provider put that in top of notation, proof pt. called to come in or telehealth for TCM note, patient discharged from inpt. status and estimate dates. (TCM after care 2 days or 2 weeks after inpt care discharge). You can use telehealth too; modifier 95 or 93. Transitioning from the inpatient setting to the OP community, TCM is most efficiently addressed through collaborative remote patient monitoring and telemedicine services across the 30-day period covered by Medicare. Suggest providers and other HC allied professionals should write everything down while conducting a virtual patient visit as well as use a third person to conference in, record the visit, and input data into the EMR to ensure nothing falls through the cracks. Elements essential to claim approval include the following: • date and time; • length of conversation; • provider recommendations to ensure proper documented for correct coding.

Here are some examples of chronic conditions include, but are not limited to, the following: ● Alzheimer’s disease and related dementia ● Arthritis (osteoarthritis and rheumatoid) ● Asthma ● Atrial fibrillation ● Autism spectrum disorders ● Cancer ● Cardiovascular Disease ● Chronic Obstructive Pulmonary Disease ● Depression ● Diabetes ● Hypertension ● Infectious diseases such as HIV/AIDS.

Well hope this data helps you :)
Lady T
 
TThivierge said:
Hello JBHUJU,:)
Providers can extract greater value from transitional care management (TCM). CPT codes 99495 and 99496 support management and coordination of services for moderately complex patients and highly complex patients, respectively, following discharge from hospitals, long term care and skilled nursing facilities, and other inpatient settings. Ensure provider put that in top of notation, proof pt. called to come in or telehealth for TCM note, patient discharged from inpt. status and estimate dates. (TCM after care 2 days or 2 weeks after inpt care discharge). You can use telehealth too; modifier 95 or 93. Transitioning from the inpatient setting to the OP community, TCM is most efficiently addressed through collaborative remote patient monitoring and telemedicine services across the 30-day period covered by Medicare. Suggest providers and other HC allied professionals should write everything down while conducting a virtual patient visit as well as use a third person to conference in, record the visit, and input data into the EMR to ensure nothing falls through the cracks. Elements essential to claim approval include the following: • date and time; • length of conversation; • provider recommendations to ensure proper documented for correct coding.

Here are some examples of chronic conditions include, but are not limited to, the following: ● Alzheimer’s disease and related dementia ● Arthritis (osteoarthritis and rheumatoid) ● Asthma ● Atrial fibrillation ● Autism spectrum disorders ● Cancer ● Cardiovascular Disease ● Chronic Obstructive Pulmonary Disease ● Depression ● Diabetes ● Hypertension ● Infectious diseases such as HIV/AIDS.

Well hope this data helps you :)
Lady T
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thank you so much.
 
cherylaconte@gmail.com said:
Clinicians must make interactive contact within 2 business days following the patient discharge to the community setting. The contact may be via telephone, e-mail, or a face-to-face visit within two business days.

For Medicare purposes, attempts to communicate should continue after the first two attempts in the required 2 business days until they are successful.

A successful attempt requires a direct exchange of information and appropriate medical direction by clinical staff with the patient and/or caregiver.
Click to expand...
thank you so much.
 
What if the patient contacts the provider through their chart app before the provider was able to reach out to them? Does the TCM have to be initiated by the provider in order to bill for it?
 
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