tci General Surgery Coding Alert - 2016 Issue 9

Reader Question: Determine 'Clinical Staff' Eligibility for TCM

Question: I work in a general surgery office and have some questions concerning codes 99495-99496 (Management of transitional care services…). Can we use these codes in our office as a billable service by “clinical staff,” and if so, who is considered “clinical staff”? New York Subscriber Answer: The Transitional Care Management (TCM) codes require one face-to-face visit with a physician or qualified healthcare provider, but the “clinical staff” can and probably will provide the rest of the services, either in the clinic or possibly in the hospital. These services often include some monitoring services...

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