I have a patient who was discharged from a hospital admission to a skilled nursing facility.
My office is saying it's totally fine to still bill the TCM. My interpretation is that we can't bill a TCM because that is an inpatient (hospital) to inpatient (SNF because they have 24/hr care) and patient was not discharged home.
They also did not provide me with clinicals from the SNF. Per CMS guidelines and MLN matters I think I am right and we can't bill the TCM but everyone else says we can. Has anyone else come across this?
Do you have documentation that explains that they can't or can outside of AAPC and CMS?
If I'm just wrong that's ok but I just don't want to send out claims that are incorrect. Please and thank you for any help.
I am coding for a family practice, outpatient only.
AFP, CPC
My office is saying it's totally fine to still bill the TCM. My interpretation is that we can't bill a TCM because that is an inpatient (hospital) to inpatient (SNF because they have 24/hr care) and patient was not discharged home.
They also did not provide me with clinicals from the SNF. Per CMS guidelines and MLN matters I think I am right and we can't bill the TCM but everyone else says we can. Has anyone else come across this?
Do you have documentation that explains that they can't or can outside of AAPC and CMS?
If I'm just wrong that's ok but I just don't want to send out claims that are incorrect. Please and thank you for any help.
I am coding for a family practice, outpatient only.
AFP, CPC
