Forum - Questions & Answers

Apr 8th, 2013 - amym

TCM denial

I also recvd denials on 99495. Denial code N357. I am very confused about the billing requirments of theses codes. Should we hold the claim for 30 days but bill with the date the service was provided? I'm thinking its just more hoops for us to jump thru. Any help would be appreciated.

Apr 8th, 2013 - bsergi 110 

re: TCM denial

Bill for dos provided. "Transitional Care Management Services with the following required elements: Communication (direct contact, telephone, electronic) with the patient 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."
TCM commences upon the date of discharge and continues for the next 29 days.



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