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Wiki Transitional Care Management

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LeighR

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Olive Branch, MS
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We are trying to bill Transitional Care Mgmt-Moderate (99495) to Cigna, but have received a denial.
N572: THIS PROCEDURE IS NOT PAYABLE UNLESS APPROPRIATE NON-PAYABLE REPORTING CODES AND ASSOCIATED MODIFIERS ARE SUBMITTED.
This is the first time that I am seeing this denial. Does anyone have experience billing these codes and know which code/modifier they might be looking for?
I am researching it online, but figured I would ask here as well.
Thank you in advance!!
 
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Cigna posted that on Feb 15th, 2020 they were no longer going to pay for Transitional care codes. We will appropriate E/M level codes for these visits as of that date.
 
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