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Wiki Billing TCM & G0506 Together

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kaladickerson

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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!
 
TCM and CCM planning

kgardner05 said:
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!
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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
 
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