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Jason C Bellucci

jason Posted Wed 04th of March, 2020 15:15:21 PM
Can we bill a 99214 or 99215 or 99213 with CPT code 99495 or 99496 on the same day? Can we see a patient for other services besides the Transition of Care ICD 10 and bill the E/M code(99213,99214,99215) with a different ICD 10? Example: if patient is discharged for Diabetes and is seen for during Transition of Care for the Diabetes and also seen Hypertension can we bill a 99495 and a 99213 on the same day?
SuperCoder Answered Thu 05th of March, 2020 04:54:01 AM

Hi Jason,

Not if the 99213 visit is the one visit included in TCM. CPT states, "The first face-to-face visit is part of the TCM service and not reported separately. Additional E/M services provided on subsequent dates after the first face-to-face visit may be reported separately".

Also, when billing 99213 and 99495 together, the condition of the patient should not be related to each other service. And make sure your documentation does not overlap of TCM and office visit. It is also suggested to check your payer policy related to TCM and office visit billing together, if any.

Hope this helps!

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