Transitional Care Management (TCM) Services

There is a lot of confusion surrounding reporting for transitional care management (TCM) services. CPT offers the following options to report TCM services: 99495 – Transitional Care Management services with the following required elements: communication (direct contact, telephone, electronic) with the patient and/or caregiver within 2 business days of discharge; medical decision making of at least…

How the CMS Final Rule will Affect Orthopedic ASCs: 5 Key Notes

On Nov. 2, CMS received the 2018 final payment rule, providing a 1.2 percent increase in ASC reimbursement next year. The final rule also addressed several issues pertaining to orthopedic procedures in ASCs, including total joint replacements and spine procedures. Here are five ways the final rule will affect orthopedic ASCs, according to guidance from…

UHC No Longer Reimbursing for Consult Codes

UHC No Longer Reimbursing for Consult Codes

Effective for claims with dates of service on or after Oct. 1, 2017, UnitedHealthcare will reimburse the appropriate evaluation and management (E/M) procedure code which describes the office visit, hospital care, nursing facility care, home service or domiciliary/rest home care reported in lieu of a consultation services procedure code. This notification will be the first…

Code Spotlight — ICD-10 Code I16

Code Spotlight — M48.062 Spinal Stenosis Lumbar Region with Neurogenic Claudication

RT Welter & Associates is excited to present our monthly Code Spotlight! Each month, RT Welter & Associates will spotlight a unique CPT or ICD-10 code to profile and discuss practice applications of the code, as well as pertinent guideline reminders. M48.062 – Spinal Stenosis, lumbar region, with neurogenic claudication The list of ICD-10 code updates is…