Question: What types of discharge fall under the transitional care management codes?
Answer: The evaluation and management transitional care management (TCM) codes you mention are:
With TCM, the provider delivers services during the patient's transition back home following particular kinds of discharge, according to Maggie M. Mac, CPC, CEMC, CHC, CMM, ICCE, AAPC Fellow, AHIMA-approved ICD-10 CM/PCS trainer, and president of Maggie Mac-Medical Practice Consulting in Clearwater, Florida.
The eligible inpatient hospital discharge settings include the following, according to the CMS TCM Services Guide:
After discharge from an inpatient setting, the patient must return to his community setting (where he will reside), which includes the following, according to the CMS TCM Services Guide:
Caution: The requirements are specific to the patient being discharged from the inpatient hospital setting to his community setting, not to another facility. You cannot bill a TCM code if the patient is discharged from one inpatient facility to another such as from inpatient to a skilled nursing facility.