E/M Coding Alert - 2015 Issue 13
Learn From CCM FAQs to Prevent Claims Denials
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Article Overview
This FAQ-style article discusses Medicare chronic care management billing at a high level, focusing on common provider questions about reporting periods, qualifying personnel, and access-to-care expectations. It is aimed at physicians, non-physician practitioners, and billing/coding staff who want to understand the general requirements and compliance themes associated with CCM claims.
Why This Topic Matters
Understanding the billing and operational basics of chronic care management can help practices reduce avoidable claim problems and align workflow with Medicare expectations.
Article Sections
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Chronic care management billing FAQs
Introduces the common questions raised by providers about Medicare chronic care management services and sets up the scope of the discussion.
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Reporting period and date of service
Addresses how the service period is viewed for monthly reporting and discusses claim form timing considerations in general terms.
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Who qualifies as clinical staff
Reviews which types of practitioners and practice personnel may be relevant to CCM reporting and mentions Medicare-related supervision and scope considerations.
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24/7 access to care
Explains the article’s focus on after-hours access expectations and the general requirement for patients to be able to contact the practice for care management needs.
What You Will Learn
- How chronic care management billing is discussed on a monthly basis
- Which categories of personnel may be relevant to CCM reporting
- Why access-to-care expectations matter for CCM claims
- How common billing questions can affect denial prevention workflows
Who Should Read This
- Physicians
- Non-physician practitioners
- Medical billing staff
- Coding professionals
- Practice managers
Codes Discussed
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