Wiki The new date of service rule for billing transitional care management

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nsal223

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Hello all, I was wondering if anyone had any insight on this new ruling for the TCMS. I am aware that the 30 day wait is no longer and we can bill the TCM on the date of the face to face, however, do we bill the office visit and the TCM? Or do we bill the TCM in place of the face to face? Thank you in advance!!!

Nicole M.
 
Tcm

You can't bill an E/M and the TCM code on the same DOS. TCM covers the patient for a 30 day period after they are d/c'd from the hospital. If the pt needs to be seen again by your provider during that 30 day period for a reason NOT related to their TCM visit, you can bill an E/M code. i.e. they have a finger laceration or the flu, etc.
Hope this helps! I am myself searching for the revised policy that states that the DOS billed on the claim is the date of the face to face visit with the provider...
 
In writting

nsal223 said:
Hello all, I was wondering if anyone had any insight on this new ruling for the TCMS. I am aware that the 30 day wait is no longer and we can bill the TCM on the date of the face to face, however, do we bill the office visit and the TCM? Or do we bill the TCM in place of the face to face? Thank you in advance!!!

Nicole M.
Click to expand...

Can you tell me where I can find this in writing. I have been looking all over.
Thank you,
Damey
 
Transitional Care Management

I can't find Medicare's official word on the new date of service rule. I was directed to the Final Rule which was released on October 30th in the Federal Register under Improving Payment Accuracy for Primary Care and Care Management Services. Can't find it there. Can anyone help with this?


Andrea Bowers, CMM, CPC, CPMA
 
Another question to the TCM

What if the patient is readmitted within the 30 day period and we have already submitted the charge for the TCM?
 
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