Wiki MDM for Transitional Care Management (TCM)

[firetorah]

Sorry to post a new thread but I can't find an answer anywhere. Here goes...

When calculating the complexity of medical decision making for a TCM (99495, 99497), do I use the MDM definitions/grid from the 1995/1997 AMA documentation guidelines or the new MDM definitions/grid from the 2021 AMA documentation guidelines? It's surprisingly hard to get a straight answer to this question.

My logic says that the new 2021 documentation guidelines (and their MDM definitions/grid) apply only to E/M encounters 99202-99215. TCMs were not included in the new guidelines and therefore we should use the MDM definitions/grid from the 1995/1997 documentation guidelines.

Ok, there you have it. Which guidelines do I use to calculate the complexity of MDM for a TCM 99495 or 99496?

 

[lcolborn]

You are correct. The TCM does not follow the new 2021 E/M Guidelines . 1995 or 1997 MDM is what we have to follow with the TCM.

 

[firetorah]

Thank you very much. I just looked at the question long enough that I began to second guess myself. There were some ninnies posting contradictory information on the University of Google (no surprise there) so I just wanted to make double dog darn sure.

 

[Orthocoderpgu]

Thank you very much. I just looked at the question long enough that I began to second guess myself. There were some ninnies posting contradictory information on the University of Google (no surprise there) so I just wanted to make double dog darn sure.

Why were you doubting yourself? You already had the answer.

 

[jld26501]

Were any of you able to find it in writing? We are using the 95/97 guidelines for mdm for tcm too but now we are being told we have to use the 2021 AMA table or MDM. I would appreciate any help you can provide.