Wiki TCM - Need clarification please

[StacyGalloway]

I was just told my a Medicare rep that the TCM should be billed as follows....
TCM DOS should have the 7th business day as the date of service, and then to be billed out on the 30th day. I have a problem with this only because what happens when the patient doesn't come in until the 10th or 12th day after hospital discharge? It seems wrong. But at this point we are trying anything to get these paid as we have billed them out with the correct DOS listed and then actually submitted them on the 30th day which didn't work. I do not like this code because it seems as though it is a guessing game to get paid.

Any clairification would be OUTSTANDING as to what DOS to use and WHEN to bill these crazy things.

Thank you in advance,

Stacy, CFPC

 

[mhstrauss]

I was just told my a Medicare rep that the TCM should be billed as follows....
TCM DOS should have the 7th business day as the date of service, and then to be billed out on the 30th day. I have a problem with this only because what happens when the patient doesn't come in until the 10th or 12th day after hospital discharge? It seems wrong. But at this point we are trying anything to get these paid as we have billed them out with the correct DOS listed and then actually submitted them on the 30th day which didn't work. I do not like this code because it seems as though it is a guessing game to get paid.

Any clairification would be OUTSTANDING as to what DOS to use and WHEN to bill these crazy things.

Thank you in advance,

Stacy, CFPC

The DOS billed out should be the 30th day after d/c, even though the patient actually came in several weeks prior. Here are the CMS FAQ's regarding this:

http://www.cms.gov/Medicare/Medicar...ment/PhysicianFeeSched/Downloads/FAQ-TCMS.pdf

Hope this helps!