decisionhealth Newsletters, Part B News - 2018 Issue 12 (December)
Tune up your coding to reap rewards in expanding CCM universe
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Article Overview
This article explains common chronic care management (CCM) coding and documentation pitfalls and outlines the broader CCM billing landscape as it expands. It is aimed at coders, billing staff, compliance teams, and clinical practices that report Medicare CCM services and need a practical overview of documentation, timing, consent, and coordination with related services. The discussion covers general CCM requirements, changes in the CCM code family, and cautions tied to Medicare claims processing.
Why This Topic Matters
CCM billing is growing and is closely reviewed for documentation completeness and timing compliance. Understanding the article’s scope helps practices decide whether they need guidance on Medicare CCM workflows, claim support, and documentation readiness.
Article Sections
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Coding
Introduces chronic care management billing trends and the documentation issues commonly associated with claims review. Sets the context for expanded CCM reporting and Medicare oversight.
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Claims rise; prepare for expansion
Reviews broader CCM adoption, Medicare claims activity, and the general features practices should understand before expanding CCM programs. Also discusses patient selection, staff roles, education, and consent workflow considerations.
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4 more elements to prepare for
Covers additional CCM operational topics involving service timing, documentation of interactions, care coordination with transitional services, and diagnosis-related claim handling.
What You Will Learn
- The general documentation areas that affect CCM claim acceptance
- How CCM expansion changes practice workflow planning
- What broad timing and consent topics are emphasized for CCM reporting
- How CCM may intersect with related Medicare service periods
- What kinds of claim-processing issues can arise in CCM billing
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Practice managers
- Physicians
- Non-physician practitioners
- Clinical staff involved in care management
Codes Discussed
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