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New Tools Clarify Transitional Care Management CPT Codes
By News Staff
The AAFP has created two free tools to help members get comfortable assimilating the new codes into their billing processes.
The first tool, a frequently-asked-questions (FAQ) document (2-page PDF; About PDFs) provides concise answers to 21 basic questions about the new codes. For example, the FAQ sorts out
- when to use TCM code 99495 versus 99496,
- coverage of services delivered in a manner other than face-to-face,
- expected payment for each code,
- specific time elements associated with the new codes, and
- circumstances that would limit physician use of either TCM code.
- interactive contact and seven-day and 14-day face-to-face visits;
- medications at discharge and medication changes or adjustments;
- collaboration with other health care professionals; and
- delivery of patient education about his or her illness or disease.
The last line on the form reminds FPs to submit billing 30 days after the patient's discharge.
Physicians also may find it helpful to review two entries about payment for transitional care management that were published in Family Practice Management's Getting Paid blog. The most recent blog entry posted on Feb. 12 and details some situations that have caused confusion since the codes went into effect, and a Nov. 29 blog post announces the new codes and provides a basic overview.
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