Wiki Transitional Care confusion

[0383806]

We are new to this and I am still not understanding.
Patient sees dr with in the first 7 days....dr marks a 99214 on the route...so I would bill a 99495 for the toc code?
pt sees dr with in the first 7 days...dr marks a 99215...I bill a 99496?
pt sees dr 8-14 days...no matter what he marks...I bill a 99495?

Thank you to whom ever helps!

 

[Pam Warren]

I wouldn't code the TCM based on a fee ticket with an E&M code indicated. You will need to review the documentation to determine the level of MDM. There are a number of threads on this forum that discuss TCM billing. Do a search and review the documentation criteria. You cannot bill the TCM unless you are positive that the patient has not been readmitted within 30 days from the original inpatient discharge.