decisionhealth Newsletters, Part B News - 2013 Issue 7 (July)
Streamline TCM coding to earn as much as $90 more for care coordination
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Article Overview
This article discusses transitional care management (TCM) billing in a practice-management context, focusing on documentation, staff workflow, reimbursement comparison, and common billing questions. It is aimed at physicians, coders, billers, and practice managers who want to understand the general requirements and operational steps involved in supporting TCM claims. The article also references CMS guidance and practice tools used to help coordinate post-discharge care and manage claims accurately.
Why This Topic Matters
TCM billing can affect revenue and compliance for practices that coordinate care after discharge. Understanding the general workflow, documentation expectations, and payer guidance helps practices decide whether and how to support these services effectively.
Article Sections
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TCM overview and reimbursement context
Introduces transitional care management as a billing opportunity and explains why practices are evaluating the administrative effort involved. It also places the topic in the context of payment and care coordination.
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6 tips to streamline TCM coding
Presents operational guidance for practices considering TCM workflows, staffing, documentation, billing boundaries, and Medicare-related considerations. The section focuses on implementation topics rather than clinical content.
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Resources
Lists referenced external tools and payer guidance sources used for further reference on TCM workflow and documentation support.
What You Will Learn
- How TCM is framed as a care-coordination billing topic
- What types of practice workflows support TCM documentation
- Why staff documentation and tracking processes matter
- What general billing and payer considerations are discussed for TCM
- Which external resources are referenced for TCM support
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physicians
- Clinical office administrators
Codes Discussed
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