AMA CPT® Assistant - 2013 Issue 7 (July)
Evaluation and Management: Transitional Care Management Services (Q & A) (July 2013)
July 2013 page 11 Evaluation and Management: Transitional Care Management Services Question: How are the new Transitional Care Management Services codes reported? Answer: Codes 99495 and 99496 are used to report transitional care management services (TCM). TCM commences upon the date of discharge and continues for the next 29 days. TCM requires one face-to-face visit within the time frame associated with the specific TCM code being reported, in combination with non - face-to-face services that may be performed by the physician or other qualified health care professional and/or licensed clinical staff under the physician's direction. The choice of which...
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Article Overview
This Q&A article explains the scope of transitional care management services and the documentation, timing, and reporting considerations associated with them. It is intended for coders, billers, and clinicians who need a clearer understanding of how the guidance is presented in CPT Assistant and how related care plan oversight and discharge-related services are discussed. The article focuses on general reporting guidance, service periods, communication requirements, and payer variation.
Why This Topic Matters
Transitional care management is a frequently used evaluation and management service, and correct reporting depends on understanding service timing, documentation, and coordination with other related services. This article helps readers assess whether their billing and documentation processes align with CPT Assistant guidance.
Article Sections
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July 2013 page 11
Introductory publication information and placement within the source issue.
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Evaluation and Management: Transitional Care Management Services
A question-and-answer discussion of transitional care management services, including reporting, documentation, timing, and coordination issues.
What You Will Learn
- How transitional care management services are addressed in the article
- What documentation categories are discussed for reporting support
- What timing and reporting issues are highlighted
- How the article frames related service interactions and reporting relationships
- What general payer and reporting considerations are mentioned
Who Should Read This
- Medical coders
- Billing staff
- Physicians
- Other qualified health care professionals
- Compliance staff
Codes Discussed
Code Ranges Discussed
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