Coding Intel

Medical coding resources for physicians and their staff. CodingIntel was founded by consultant and coding expert Betsy Nicoletti.

Wondering about Transitional Care Management?

A Video Overview of TCM Codes Finally, payment for services practices typically do for free! Transitional Care Management (TCM) provides payment to medical practices for helping complex patients transition from a facility to a non-facility setting, for example, from the hospital to home. It pays for the provider and clinical staff to perform non-face-to-face services and get paid for the work. Watch this 15 minute video courtesy of CodingIntel … [Read more...]

Transitional Care Management

An Overview of TCM Services and CPT 99495 & 99496 This article provides details about billing for TCM services, and includes the comparative RVUs for TCM and established patient visits. Please note, RVUs listed are for 2016.  CodingIntel will be updating them to the 2017 values shortly to display the newest codes for billing for transitional care management. CPT 99495: Transitional Care Management (TCM) Services with the following required … [Read more...]

Performing services that increase primary care revenue

CMS states it wants to increase pay to primary care physicians. And while we might quarrel with their strategies or with the speed of achieving the goal, few would quarrel with the goal itself. In recent years, CMS has developed HCPCS codes and adopted CPT codes, some limited to primary care and some not specialty restricted but all likely to be reported by primary care practices. Meanwhile, although payment systems are moving to outcome and … [Read more...]

Can’t I Bill TCM for all Discharged Patients? Rules and Comments

An Overview of Transitional Care Management CPT & TCM for Discharge “I can bill all discharges with Transitional Care Management codes.  They’re all moderate complexity” Recently, a client wrote to me about a physician who wants to use the Transitional Care Management (TCM) codes for all discharges.  The physician stated that all patients who were discharged from the hospital had at least moderate complexity on the day of discharge and … [Read more...]

Transitional Care Management (TCM) update

Here's the latest on Transitional Care Management Services: Date of service: use 29th day following discharge or counting day of discharge as day one, day 30. Place of service: use place where mandated, bundled face-to-face E/M occurred. What does licensed clinical staff mean?  No clarification yet from CMS.  FAQ being developed by them.  All staff must practice within their state scope of practice. If patient is re-admitted during 30 … [Read more...]

Our mission is to provide accurate, comprehensive, up-to-date coding answers, allowing medical practices to increase revenue, decrease coding denials and reduce compliance risk. That's what coding knowledge can do.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 22,100 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 40,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

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