(2014 Evaluation and Management Code Changes continued) counted only once, not twice. The 2014 guidelines establish the following new requirements for the office or practice that is coordinating the care: • around-the-clock (24/7) access to physicians/practitioners or clinical staff • a standardized methodology to identify patients who require these services • an internal coordination process to ensure that patients who are identified as candidates for these services begin receiving them promptly • a medical record form and format that is standardized within the practice • The ability to engage and educate patients and caregivers and to coordinate care among service providers, as appropriate Finally, care plan oversight in the nursing home setting (codes 99379–99380) has been added to the list of services that are included in complex chronic care coordination and should not be billed separately. Transitional Care Management like the complex chronic care coordination codes, the transitional care management (TCm) codes were added to the CPT code set in 2013. The TCm coding guidelines have been revised slightly 34 HBma BIllIng • maRCH.aPRIl.2014 for 2014, although the codes themselves have not changed. last year, the TCm codes could be reported only for the physician’s or practitioner’s established patients. For 2014, they may be used for both new and established patients. In 2013, the guidelines stated that the physician/practitioner could bill separately for “additional e/m services after the first face-to-face visit.” For 2014, the guidelines have been revised to clarify that the additional e/m services can be reported separately only if performed on a subsequent date. as in 2013, the same physician or practitioner can report hospital discharge management (either inpatient or observation) in addition to TCm. However, the 2014 guidelines clarify that the discharge service cannot serve as the required face-to-face visit for the TCm. Finally, the guidelines have been revised to clarify that TCm should not be reported in the postoperative period of a service that the TCm provider reported. In other words, a physician can report TCm within the postoperative period of a surgical procedure performed by a different provider. Conclusion In addition to the changes discussed in this column, there are also changes to the pediatric critical care transport codes and the neonatal hypothermia codes. Billing professionals who work with pediatric services should review these changes in the CPT manual to ensure correct code assignment. Jackie Miller, RHIA, CCS-P, CPC, PCS, is vice president of product development at Coding Strategies, Inc. A Few Ways to Obtain CHBME Credits Attend HBMA conferences Take the quiz in Billing Purchase videos by module from the Executive Summit (located at the website) ICD-10 will become effective on October 1, 2014. Have you utilized the HBMA resources to begin training staff and clients? TIME IS RUNNING OUT.
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