Wiki CCM denials for incident-to requirements not met.

[gcmc11528]

We are getting claim denials for CCM billing due to incident-to requirements not met. We are unsure how to correct this issue. Would the claim deny if the plan of care was signed by one doctor but the claim was billed under a different doctor in the practice. We can't figure out what the problem could be other than maybe the plan of care and billing provider is not the same. Does anyone have any insight for us on what we are doing wrong?

 

[LHelmers]

CCM should only be billed under the provider with the plan of care. I asked my CCM biller, and she said we never bill CCM under a PA due to the incident-to requirements. (She said they know you CAN, but she said we don't.)