tci Medicare Compliance & Reimbursement - 2013 Issue 5
MAC Spotlight: Wait For Clarity On TCM Rules To Emerge
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Article Overview
This article reviews Medicare contractor commentary on transitional care management billing and the introduction of new therapy-related reporting requirements. It is useful for billing staff, coders, and compliance teams following CMS implementation timelines, MAC communications, and claim-processing changes for post-discharge care and therapy services.
Why This Topic Matters
It helps readers understand the kinds of Medicare payment and reporting changes being discussed by a MAC, including where CMS guidance was still pending and where claims-processing expectations were changing.
Article Sections
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Transitional care management guidance from NGS Medicare
Discussion of contractor comments on new transitional care management services, CMS direction, and related Medicare payment considerations.
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July 1 is go time for new therapy codes
Overview of the rollout timeline for therapy-related reporting changes, including the testing period, claim-processing expectations, and examples referenced in the article.
What You Will Learn
- How Medicare contractor commentary framed transitional care management guidance
- What general implementation issues were still awaiting CMS clarification
- How the article describes the rollout timeline for new therapy reporting requirements
- What kinds of Medicare claim-processing changes were associated with the new therapy codes and modifiers
Who Should Read This
- Medical coders
- Billing staff
- Compliance teams
- Therapy practice managers
- Revenue cycle professionals
Codes Discussed
Modifiers Discussed
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