Forum - Questions & Answers

Apr 21st, 2014 - anast203 2 

Transition Care Management

Our primary care physician saw a patient within 14 days of discharged from hospital. The Doctor has coded the visit as TCM 99495. He also coded E&M code 99214 with 93000 because the patient has a new diagnosis of A-Fib.
How do we bill this visit as TCM has to be billed after 30 days of discharge? Can we bill office visit and EKG with modifier during the TCM period. If so, would we bill with Modifier 25? Do we bill it as separate claim - one for OV and EKG for current date and another for TCM on 30the day of discharge?
Help!!



Apr 21st, 2014 -

re: Transition Care Management

Transitional Care includes one office visit. You would not bill the office visit. However, You would bill the EKG. I normally separate the charges, and put the transitional care code DOS 30 days after discharge and put a hold on that claim. As for the EKG, put the date of service as the date it was rendered and submit that right away, separately.



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