tci E/M Coding Alert - 2018 Issue 7

You Be the Coder: Let Location Determine TCM Code Choice

Question: What types of discharge fall under the transitional care management codes? New Mexico Subscriber Answer: The evaluation and management transitional care management (TCM) codes you mention are: 99495 — Transitional Care Management services with the following required elements: communication (direct contact, telephone, electronic) withthepatient and/or caregiver within 2 business days of discharge medical decision making of at least moderate complexity during the service period face-to-face visit, within 14 calendar days of discharge 99496 — ... medical decision making of high complexity during the service period face-to-face visit, within 7 calendar days of discharge). With TCM, the provider delivers services...

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