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Wiki PCP billing TCM for routine TKA by Ortho

SUEV

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Local Chapter Officer
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Kennebunk, ME
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I'm hoping someone can shed some light on this subject. The MLN guide for TCMs state"You may not bill TCM services and services that are within a post-operative global period (TCM services cannot be paid if any of the 30-day TCM period falls within a global period for a procedure code billed by the same practitioner)." Should this be interpreted to mean that the PCP can bill for a TCM after the patient's been discharged from the hospital for a scheduled knee replacement? There were no complications during the hospital stay and the chronics that were addressed are all stable with no mention of them being affected during the admission. Since there are 3 chronics, 99495 could be supported but this was not an unplanned admission. Does everyone bill for it anyway?
Thanks,
Sue
 
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