decisionhealth Newsletters, Part B News - 2018 Issue 3 (March)
CCM and TCM: 4 tips to craft a seamless care management coding plan
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Article Overview
This article discusses Medicare transitional care management and chronic care management coding from a practical practice-management perspective. It focuses on the service requirements, documentation and workflow considerations, use of vendors and EHR support, and the operational steps practices should review when building or expanding care management programs. It is intended for coders, billers, practice administrators, and clinicians responsible for care management compliance and revenue capture.
Why This Topic Matters
Care management services can create important revenue opportunities while also supporting continuity of care between visits. Understanding the general Medicare requirements and operational considerations helps practices reduce denial risk and build sustainable workflows.
Article Sections
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Coding
Introduces care management coding in the Medicare environment and discusses the growing use of transitional and chronic care management services.
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Stick to the script to maintain coding compliance
Reviews the importance of meeting required timelines and documentation elements for care management services and notes common workflow pitfalls.
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Build the service elements into your workflow
Describes ways practices organize care management documentation and record-keeping within office workflows to support compliance and audit readiness.
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Consider a vendor to fulfill your CCM services
Summarizes outsourcing and vendor-supported approaches for care management program operations, including coordination and patient engagement.
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Be honest about the resources you’ll need to get started
Covers planning considerations for staffing, EHR support, patient identification, and the resources needed to launch and sustain a care management program.
What You Will Learn
- How the article frames Medicare care management services at a high level
- Which operational areas matter most when building a care management workflow
- What kinds of documentation and coordination topics are emphasized
- Why vendors and EHR tools may be part of a care management strategy
- What resource-planning issues practices should consider before expanding care management services
Who Should Read This
- Medical coders
- Billing staff
- Practice administrators
- Physicians
- Clinical care teams
- Revenue cycle professionals
Codes Discussed
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