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Issue #7 - March 6, 2013

Coding/Billing Tips and Resources

Transitional Care Management: Worth the Effort
By Raemarie Jimenez, CPC, CPMA, CPPM, CPC-I, CANPC, CRHC

New transitional care management (TCM) codes, introduced in CPT® 2013, allow providers to receive reimbursement for their efforts and the efforts of their staff to promote successful outcomes for patients transitioning from a facility setting (e.g., inpatient hospital, nursing facility) to a community setting (e.g., home, assisted living facility).

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3 Tips Guide Successful Incident-to Billing

Incident-to billing can be tricky. Services and supplies properly provided and billed incident-to a physician’s or non-physician practitioner’s services are reimbursed at 100 percent of the Medicare fee schedule amount for Medicare beneficiaries, providing an opportunity for practices to make the most of their auxiliary staff—but only if they adhere to the Center for Medicare & Medicaid Services’ (CMS) strict incident to requirements. The following quick tips help you cover the basics.

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Eye Exams vs. E/M Codes: Making the Proper Selection

Both general ophthalmological services (92002-92014) and evaluation and management (E/M) codes (99201-99215) describe office visits for new or established patients. So, when should you apply the ophthalmological services codes rather than the E/M codes?

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