Wiki TCM services

[bharathiT]

Kindly clarify the below case,

patient come for TCM service on 09/04/2019 on NY state . Patient previously admit in inpatient settings 09/02/19 & discharged at 09/03/19 at NJ state. In this case can we bill TCM on 09/04/19.

Bz, Doubt is both are different state.

(or) want to bill E/M for patient on 09/04/19.

 

[thomas7331]

There is no regulation or coding guideline that I am aware of that requires that the TCM service be performed in the same state as the inpatient stay. The choice of code should be based on what most accurately reflects the documented service unless your payer specifically instructs otherwise.

Here is the CMS guidance on TCM billing - it does not mention anything about this being a state-specific service:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Transitional-Care-Management-Services-Fact-Sheet-ICN908628.pdf

 

[bharathiT]

Thank you for information.