AMA CPT® Assistant - 2014 Issue 10 (October)
Coding Update: Care Management Services (October 2014)
October 2014 pages 3-5 Coding Update: Care Management Services The Complex Chronic Care Coordination Services subsection of the Evaluation and Management (E/M) section was revised to Care Management Services for the 2015 Current Procedural Terminology (CPT) code set. The rationale for these changes is to create services consistent with Centers for Medicare and Medicaid Services (CMS) guidelines for the management of care provided for patients with chronic conditions that require care performed by multiple disciplines and community service agencies. This article illustrates the services provided by advanced clinical practices, the attributes that define such practices, and the reporting requirements...
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Article Overview
This article reviews the 2015 CPT revision that renamed and reorganized care management content within Evaluation and Management. It summarizes the care management framework, the role of clinical staff and supervising professionals, practice requirements, and the reporting scope for monthly care management services. The piece is aimed at coders, billers, and clinical practice staff who need to understand the structure and documentation expectations associated with these services.
Why This Topic Matters
Care management coding changes affect how practices document, coordinate, and report ongoing support for patients with chronic conditions. Understanding the update helps readers recognize the type of services covered, the operational requirements of a compliant practice, and the code families discussed in the article.
Article Sections
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Care Management Services
Introduces the care management framework, the types of patients and settings involved, and the general practice capabilities associated with these services. It also outlines the monthly reporting structure and related service categories discussed in the update.
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Chronic Care Management Services
Summarizes the chronic care management portion of the update, including the main service concept, time-based reporting framework, and the broad characteristics of patients addressed by this category.
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Complex Chronic Care Management Services
Reviews the complex chronic care management category, including the broader service requirements, time-based reporting structure, and the general patient characteristics and practice considerations described in the article.
What You Will Learn
- How the 2015 care management update restructured this area of CPT
- What broad practice capabilities are associated with care management services
- How monthly care management reporting is organized at a high level
- What categories of patient needs and care coordination are discussed
- How the article frames chronic versus complex chronic care management
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physicians and other qualified health care professionals
- Clinical staff involved in care coordination
Codes Discussed
Code Ranges Discussed
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