decisionhealth Newsletters, Coder Pink Sheets - 2013 Issue 3 (March)
CPT 2013: If TCM patient is readmitted, consider timing, length of second stay
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Article Overview
This article explains how transitional care management coverage is affected when a recently discharged Medicare patient is readmitted during the 30-day service window. It is intended for coders, billers, and compliance staff who handle Medicare evaluation and management services and need to understand the general considerations discussed by CMS and CPT in the context of repeated discharges.
Why This Topic Matters
Readmissions can affect whether a transitional care management service is billed once or whether a new postdischarge period begins. The article helps readers understand the broad Medicare and CPT policy context for these scenarios.
What You Will Learn
- How readmission timing can affect transitional care management billing context
- Why the length of a second hospital stay may matter in postdischarge service periods
- How CMS and CPT are discussed in relation to limiting repeated transitional care management reporting
- What general policy themes are associated with 30-day postdischarge service windows
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Physician practice managers
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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