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Wiki TCM

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luvbuix

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Seymour, WI
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I work for an oncology practice & our pts are typically in & out of the hosp numerous times during the course of tx. My questions are: Once the 29 day mgt period is over can they bill these codes again on the same pt? They are always the care coordinators due to comorbidities & toxicity so they do alot of care mgt but how frequently can they bill these codes during the course of tx?? I'd like for them bill it as a one-and-done to prevent abuse.
 
Yes, you can (and should) provide TCM services for patients at each of their post-hospitalization discharge periods, as long as they're not readmitted during that 29-day requirement. So if a patient has two subsequent admissions with discharges each 30+ days apart, and you manage TCM for both of those discharges, you can bill both. TCM is not one-and-done. It's a post-discharge care management program to prevent readmissions each time the patient is admitted.
 
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