AMA CPT® Assistant - 2013 Issue 8 (August)
Evaluation and Management: Transitional Care Management Services (Q&A) (August 2013)
August 2013 page 13 Evaluation and Management: Transitional Care Management Services Question: Can transitional care management (TCM) services be reported if the patient is on hospice, for instance if the patient was discharged home on home hospice services? Answer: Yes. It would be appropriate to report the TCM services codes, 99495 , Transitional Care Management Services with the following required elements: Communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge; Medical decision making of at least moderate complexity during the service period; Face-to-face visit, within 14 calendar days of discharge, and 99496 , Transitional...
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Article Overview
This article discusses CPT evaluation and management guidance for transitional care management services in the context of a hospice-related discharge question. It is useful for coders, billers, and clinicians who work with post-discharge care coordination and need to understand the general applicability of CPT transitional care management guidance.
Why This Topic Matters
Transitional care management reporting can be affected by discharge context and the surrounding care setting, so this article helps readers understand where CPT guidance applies in a hospice-related scenario without assuming the answer from the title alone.
Article Sections
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August 2013 page 13
Publication information for the Q&A item.
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Evaluation and Management: Transitional Care Management Services
A question-and-answer discussion focused on CPT transitional care management guidance in a post-discharge setting.
What You Will Learn
- The general scope of transitional care management guidance in CPT
- How the article frames a hospice-related discharge question
- Which broad service components are discussed in relation to transitional care management
- How this Q&A fits within evaluation and management guidance
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Clinicians involved in post-discharge care coordination
Codes Discussed
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