decisionhealth Newsletters, Part B News - 2017 Issue 6 (June)
You can claim TCM for patients who elect hospice — if they’re at home
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Article Overview
This article explains how transitional care management coverage is discussed for patients who elect hospice, with emphasis on whether the discharge setting affects billability. It is relevant to coders, billers, and clinicians who need to interpret Medicare and contractor guidance on transitional care management in post-discharge care scenarios. The article reviews general requirements, hospice-related context, and what sources say about community-setting discharge situations.
Why This Topic Matters
Hospice, discharge destination, and transitional care management rules can affect whether a claim is considered payable. Understanding the scope of the guidance helps practices evaluate post-discharge billing situations and align documentation with payer expectations.
What You Will Learn
- How transitional care management is discussed in relation to hospice discharge scenarios
- Why the discharge setting matters for post-discharge care billing
- What kinds of external guidance are referenced in the discussion
- How related follow-up situations may affect claim handling
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Physicians and nonphysician practitioners
- Practice managers
Codes Discussed
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