Chronic Care Management and Transitional Care Management

About Course

CPT codes for Chronic Care Management and Transitional Care Management services have been around for several years. These services are designed to improve patient outcomes and reduce inpatient admissions. Many providers have not been utilizing these services for multiple different reasons while actually providing the services for free through phone calls, portal communications, etc. As our patient population ages patients with at least one or more chronic illnesses require monitoring. This program will outline the specific requirements that must be met to provide these payable services and to increase the bottom line for your office. You don’t want to miss our on earned revenue due to not understanding how these codes may be utilized in your office.

Learning Objective

Make the most of payable chronic care and transitional care services to improve your office’s bottom line and to provide quality care to your patients
Identify who may provide these services
Define principal care management and who can bill for managing a patient with a single high-risk disease
Understand the elements and requirements for billing transitional care management for moderate or high complexity decision making
Required documentation to support billing for transitional care management.
Understand the difference between complex chronic care management, chronic care management, and transitional care management
Identify the basic elements that must be in place to provide and bill chronic care management
Look at additional services that may be paid at the same time as chronic care management
Appropriate documentation to support chronic care management time

Areas Covered in the Session:

Chronic and complex chronic care management, 99487-99491
Principal care management G2064-G2065
Transitional Care Management 99495-99496 Co
Comprehensive assessment of and care planning for patients requiring chronic care management services G0506
Bundled services related to chronic care management and traditional care management

Suggested Attendees

Surgeons
Coding Personnel
Denial Management team
Office Managers
Insurance Payers
Physicians
Physical Assistant
Billers
Coders
Medical Assistants
Claims Adjuster
Claims Processor
Auditor
NP, APN, CNS
Executive and Administration
Compliance Officers
Charge Capture
Appeals
Medical Records Staff
A/R Staff

About the Presenter:

Jan Rasmussen, PCS, ACS-OB, ACS-GI, – As a health care consultant Jan has more than 35 years of experience in physician billing, reimbursement, and compliance. Jan is currently the owner of Professional Coding Solutions, a healthcare consulting firm. She has been a Certified Professional Coder (CPC) since 1992 with active membership in the American Academy of Procedural Coders (AAPC). As a member of the AAPC, Jan previously served on their Advisory Board as the liaison to the AMA, has been a speaker for the AAPC annual conference as well as contributing to the development of AAPC’s independent study and university education programs and proficiency tests. In 1994, she was honored by AAPC as Networker of the Year. Jan was also a Regional Governor for the American College of Medical Coding Specialists (ACMCS) serving as Chair of the Ethics committee and a member of the Examination Committee.

In her role as a physician consultant, she has participated in physician coding and documentation reviews including OIG government PATH and Campus audits, designed and conducted physician coding seminars nationwide. She has been a guest speaker for several conferences sponsored by United Communications, Inc//Decision Health, AAPC as well as Coding Institute Specialty Conferences.

In previous consulting positions she was responsible for developing and conducting seminars for basic, intermediate, and advanced ICD-9-CM and CPT, teaching physician guidelines as well as special seminars for OB/Gyn, Orthopedics, Urology, Gastroenterology, General Surgery, ENT, Cardiology, Emergency Medicine and Evaluation and Management. In her role as an educator, she has been teaching E/M documentation and auditing to both physician and coding audiences since 1992 when RBRVS was first implemented.

Jan has also worked for several major health insurance payers in Wisconsin, was a coding advisor to the WPS Medicare Carrier Advisory Committee, and served as the coding and reimbursement coordinator for a 37 provider, staff model HMO clinic. As the coding and reimbursement coordinator, Jan was responsible for physician office, hospital, surgical, and nursing facility coding charge ticket development, fee development, reimbursement analysis, claims analysis, and physician education.