Wiki Tcm 99495 & 99496

[sunshine!13]

Hello, When billing 99495 or 99496, can an EM code be billed during this 30 day period for the same diagnosis as was used with the TCM codes? Example, TCM charged for pneumonia, patient came back week later for pneumonia, can second visit be charged or is it included in the TCM since being seen for same reason?

 

[jflynn]

For TCM Services, Medicare Learning Network issued an article, ICN 908628 from June 2013, states on page 5 "Reasonable and necessary E/M services (other than the required face-to-face visit) to manage the beneficiary's issues should be reported separately". This article should provide some clarity.