Wiki Billing TCM & G0506 Together

[kaladickerson]

Hello,

Looking for some feedback on billing TCM and CCM code G0506 together. It's been brought to our attention that these are denying when billed together. Wondering if a simple -25 modifier would fix or if this isn't allowed. Can't seem to find any clear documentation in the guidelines.

Thanks!

 

[Cynthia Hughes]

TCM and CCM planning

Hello,

Looking for some feedback on billing TCM and CCM code G0506 together. It's been brought to our attention that these are denying when billed together. Wondering if a simple -25 modifier would fix or if this isn't allowed. Can't seem to find any clear documentation in the guidelines.

Thanks!

Code G0506 is only reported for comprehensive assessment and creation of a care plan in conjunction with the initiating visit for chronic care management. It would not be reported in conjunction with transitional care management. Transitional care management includes one face-to-face visit.

Cindy