decisionhealth Newsletters, Coder Pink Sheets - 2020 Issue 4 (April)
Expand your care management arsenal with new ‘principal’ management codes
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Article Overview
This premium article reviews the launch of Medicare principal care management services and places them in the broader context of chronic care management. It is aimed at coding and billing professionals who need to understand the scope of the new service category, the types of chronic conditions it addresses, the related CMS and OIG discussion, and the compliance environment around care management reporting.
Why This Topic Matters
It helps readers assess whether the new Medicare care management framework applies to their patients and workflows, while also highlighting why documentation, education, and compliance awareness matter for these services.
Article Sections
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Defining chronic illness under PCM
Summarizes the chronic conditions CMS associates with the new care management category and frames the service population discussed in the article.
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Why PCM codes may flourish
Discusses the policy and operational factors that may drive adoption of the new care management services, along with education and compliance considerations.
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Current CCM codes include 99490, 99491, 99487 and 99489
Reviews the related chronic care management code set and places it alongside audit and utilization discussion from federal oversight sources.
What You Will Learn
- How principal care management fits into Medicare care management services
- Which general chronic condition categories are associated with the new framework
- What compliance and utilization issues are raised alongside care management services
- How the article situates the new service category within broader Medicare oversight
- Which federal organizations and reports are referenced in the discussion
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Practice managers
- Physicians
- Non-physician practitioners
Codes Discussed
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