TCMS
WHAT DOES TCM STAND FOR?
What is Transition Care Management?
Within how many months of enrollment of Medicare Part B, must the Welcome to Medicare be performed?
What is within the first 12 months?
What is the letter of our shared folder?
What is 'W'?
What payor does not accept modifier 50 for cerumen removal?
What is Medicare?
You are in Epic. You are in a patient encounter. What tab on the left of your screen can you view if drugs were administered?
What is MAR or medications?
How many TCM services for the same patient during a 30 day post discharge period may be billed?
What is 1?
FYI - TCM services may be billed by only one individual during the post-discharge period. If more than one physician or NPP submits a claim for TCM services provided to a patient in a given 30-day period following discharge, Medicare will pay the first claim it receives that otherwise meets its coverage requirements.
What is the main difference between a Welcome to Medicare Visit and the Annual Wellness Visit?
What is timing?
What is the maximum hours you can work without taking a lunch?
What is six?
What is when it is a negative result?
Where can you find additional information about a vaccine that was given (NDC, lot number, etc?)
What is SnapShot?
List 3 of the 7 hospital settings from which a patient must be discharged to be 'eligible' for TCM.
What is:
Inpatient acute care hospital
Inpatient psychiatric hospital
Long-term care hospital
Skilled nursing facility
Inpatient rehabilitation facility
Hospital outpatient observation or partial hospitalization
Partial hospitalization at a community mental health center
Must the patient have a Welcome to Medicare Visit before an Annual Wellness Visit?
What is no?
What is our new on-line vendor for coding information?
What is Vitalware?
Scenario:
LABS/URINALYSIS (80000 SERIES) WITH AN E&M VISIT
Is the NSC billed or deleted?
What is bill the NSC?
If the billing department is incorrect, what action can the provider take to possibly correct it?
What is change the department login?
Who can complete the medication reconciliation for TCM?
Who is the nurse?
FYI - the nurse can obtain these but the physician needs to order any changes, additions, or deletions to the medication.
The patient is eligible for his/her first Annual Wellness Visit if the patient has been enrolled in Medicare for more than 12 months and......
What is the patient has not had a Welcome to Medicare Visit in the last 12 months?
What NP student documentation can be counted towards an E/M level?
What is ROS and PFSH?
How many MUEs does the pediatric screening 96110 allow?
What is 3?
Where can you find the cost of a procedure in Epic?
What is enterprise charge code viewer?
How is business days defined for TCMs?
What is Monday through Friday except holidays?
FYI -
For the purposes of TCM, business days are Monday through Friday, except holidays, without respect to normal practice hours or date of notification of discharge.
If two or more separate attempts are made in a timely manner, but are unsuccessful and other TCM criteria are met, the service may be reported. Medicare, however, expects attempts to communicate to continue until they are successful.
List the 3 of the 9 elements that must be documented for a Welcome to Medicare Visit
What are:
Medical and family history
2. List of current providers and suppliers that are
regularly involved in providing care
3. Height, weight, BMI or waist circumference, BP and
other routine measurements as deemed appropriate,
based on patient medical/family history.
4. Detection of cognitive impairment
• Risk for depression using screening instrument
(recognized)
• Functional ability and level of safety based on
direct observation or screening
questions/questionnaires
Establishment and providing a written screening
schedule (checklist) for the next 5 –10 years based on
USPSTF and ACIP.
6. List of risk factors and conditions identified and
treatment options and associated risks and benefits
7. Personalized health advice and referral to health
education or preventive counseling services or
programs to promote self-management and wellness
8. Voluntary ‘end of life’ planning.
9. “any other elements determined appropriate by the
Secretary of HHS through the NCD process”.
What are the Medicine Team's 2 goals for 2019?
What are quality and service?
What E/Ms levels for established patient can be billed as primary care exception?
What is 99211-99213?
What enterprise billing function do you click to research a professional charge billed?
What is Guarantor Account Maintenance?