General Surgery Coding Alert - 2017 Issue 10
TCM: Answer 7 Questions to Clarify How You Report TCM Codes
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Article Overview
This article explains transitional care management (TCM) reporting in the context of CPT® and CMS guidance. It is aimed at coders, billers, and clinicians who need a clearer understanding of TCM service elements, discharge scenarios, who may furnish the service, timing of contacts and visits, and related care-transition requirements. The discussion is organized as a seven-question review to help readers assess whether their situation fits TCM reporting and what general areas of guidance apply.
Why This Topic Matters
TCM services involve specific timing, setting, and staffing considerations that affect whether reporting is appropriate. Understanding the scope of the service helps coding and billing staff evaluate encounters and documentation related to post-discharge care.
Article Sections
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Master 99495 and 99496 for TCM Success
Introduces the article’s focus on transitional care management reporting and the broader service context.
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Question 1: What code choices does the 2017 CPT® manual offer for TCM?
Summarizes the CPT® code options discussed for transitional care management and the general framework for their use.
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Know What Type of Discharge Falls Under TCM
Reviews the types of discharge and care transition settings addressed in the article, along with the related CMS guidance.
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Not Sure Who Can Report TCM? Read This
Covers the types of healthcare professionals discussed as eligible to furnish transitional care management services.
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Don't Miss Interactive Contact Component of TCM
Explains the initial contact component of TCM and the general timing and communication channels referenced in the article.
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Hone in on Non-Face-to-Face Portion of TCM
Describes the non-face-to-face component of TCM and the kinds of care coordination activities referenced in CPT® and CMS guidance.
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Remember the Face-to-Face Visit
Covers the in-person visit component of TCM, related timing concepts, and documentation considerations mentioned in the article.
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Count TCM Time Period Accordingly
Addresses the overall TCM service period and how the article frames the post-discharge timeframe.
What You Will Learn
- The general structure of transitional care management services
- Which broad discharge settings are discussed in relation to TCM
- Which clinician categories are described as able to furnish TCM
- How the article frames the contact, visit, and service-period components of TCM
- What kinds of documentation and care-transition topics are associated with TCM
Who Should Read This
- Medical coders
- Medical billers
- Physician practices
- Non-physician practitioners
- Clinical documentation staff
Codes Discussed
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