decisionhealth Newsletters, Part B News - 2021 Issue 11 (November)
With code switch coming, refresh your principal care management approach
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Article Overview
This piece explains the planned shift in principal care management coding from HCPCS temporary codes to new CPT codes effective in 2022. It is aimed at coding professionals, practice managers, and billing staff who need to understand the scope of the change, the related Medicare context, and the broader care-management issues that remain relevant as practices update their workflows.
Why This Topic Matters
Practices reporting principal care management need to know which code family applies, what timing changes take effect, and what service combinations remain restricted so claims and documentation can stay aligned with payer expectations.
Article Sections
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Coding
Overview of the upcoming principal care management code transition and the Medicare context behind temporary and permanent code families.
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Add-on codes coming on board
Discussion of the additional time-based reporting options associated with principal care management and related payer review considerations.
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Do your homework
Background on foundational care management requirements, operational setup, and vendor oversight considerations for practices new to this service area.
What You Will Learn
- How principal care management coding is changing over time
- What broad categories of reporting and coverage considerations accompany the transition
- Which operational and compliance topics practices should review when offering care management services
- How add-on reporting and related payer edits are discussed in the context of principal care management
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance professionals
- Physician office administrators
Codes Discussed
Code Ranges Discussed
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