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Transitional Care Management CPT 99495-99496

  1. #1
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    Rome, Georgia Chapter - Rome Coding Professionals
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    40
    Default Transitional Care Management CPT 99495-99496
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    We have a debate going at work - According to the CMS guidelines for TCM - If a patient's condition has resolved by discharge would you still use the same diagnosis code for when the patient was in the hospital?
    Debby

  2. Default
    If the documetation states the diagnosis is resloved we do not add it to the claim. If the provider wants it in the note to "paint the picture" that is fine. But once documented as resolved it is no longer billable.

  3. Default
    Medical Billing
    In a situation like this, we were told to use the "history of..." Dx code.

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